Gordon Brown: I am grateful to my hon. Friend, who has taken a broad interest in these matters. He is absolutely right about our economic performance, given that the shadow Chancellor has congratulated us on establishing economic credibility and on our success in macroeconomic policy. On employment, despite the recent difficulties, the claimant count in Britain is 3 per cent. and the labour force survey figure is 5 per cent. Our unemployment rate is about half that of the mainland European economies'. I believe that we can continue to expand, even in a situation of massive global competition. Our aim is full employment for this country, and I hope that all parties will subscribe to that.

Gordon Brown: I can only tell the right hon. Gentleman what he himself said in his own report on the British economy:
	"What are the most attractive locations today?...The lure of the USA...Of China...Of India...Of the UK".
	We have that allure for investors because we have a low-tax economy, stability, and open competition policy. When the right hon. Gentleman chairs the Conservative party review on these matters, perhaps he can sort out its policy on Europe, which is in complete disarray according to the e-mails of the Leader of the Opposition's Parliamentary Private Secretary. Perhaps he can also say that our economic record has brought stability, whereas under the Government in which he served there was instability.

Gordon Brown: My hon. Friend is right. It was Conservative Members who talked about the cranks, fanatics and extremists that they might have to join if they were part of the opposite grouping to the European People's Party. The choice is between a pro-European and pro-business agenda and an anti-European and anti-business agenda. The tragedy is that the Conservatives are not only anti-European but are about doing what is damaging to business. If they will not believe what I have said, perhaps the Swayne e-mails—

Vincent Cable: Is not the Chancellor becoming a little concerned that Britain's good performance in terms of employment and unemployment is being undermined by the fact that unemployment has risen for 15 of the past 16 months and is at its highest point for six years? Does he have any specific initiative to make in respect of Britain's mortgage lenders, given that unemployment is translating into rapidly rising repossessions because of the absence of any system of safety nets for people in mortgage arrears?

Gordon Brown: It is difficult to take lectures from the Liberals when they have just published their tax and spending plans, which show a £20 billion spending hole that would lead to damage to the economy. As for employment, I would have thought that he would give us a balanced account. We have one of the lowest unemployment rates in Europe. At the same time, we have moved closer and faster to full employment under this Government than under any Government for 50 years.
	On interest rates, while I recognise that house prices have risen, the hon. Gentleman should recognise that interest rates are among the lowest that they have ever been. In fact, for mortgage holders, interest rates have averaged half under the Labour Government what they were under the Conservative Government. It is perhaps about time that the Liberals acknowledged that.

John McFall: The Chancellor will agree that the Lisbon agenda must be founded on the rock of economic stability. The Treasury Committee's report, "Globalisation: the role of the IMF" suggests that there is significant risk to the UK in Europe if there are global imbalances and disorderly unwinding in the global community. Given that, will my right hon. Friend ensure that, when he goes to Singapore in September, he will promote crisis prevention rather than crisis resolution so that economic stability is best served in the UK, Europe and the global community?

Tom Clarke: Would my right hon. Friend care to develop his thinking on the "education for all" programmes and the strategies of African countries, particularly in view of the need for them to be fully funded and consistent with paragraph 18(a) of the Gleneagles communiqué?

David Gauke: We have learned that, in 2003-04, nearly £1 in £10 paid in tax credits was paid either in error or because of fraud. Specifically with regard to fraud, does the Paymaster General believe that that figure will fall as a proportion of tax credits paid, and if not, why not?

John Healey: My hon. Friend is right to say that the role played by drug liaison officers overseas is pivotal. As I have explained, they have now been transferred to SOCA. He is right to stress the importance of being able to intercept drugs at every stage of the supply chain. He may be interested to know that in thefirst 10 months of last year, the agencies combined intercepted more than 30 tonnes of cocaine destined for European markets, which we would otherwise have had to try to intercept either at our borders or on our streets. That important international work is helping to keep some of our local communities freer of drugs than they would otherwise be.

Gordon Brown: Let us remind the House that the hon. Gentleman was a vicious opponent of the independence of the Bank of England. He said that it would lead to deflationary policies and higher unemployment, and that the Bank of England's reputation would be damaged. All those things proved to be untrue. On the appointments system for the Bank of England's Monetary Policy Committee, the legislation requires that we seek people with experience and expertise. That has been achieved, and the proof is in the record. It would be wrong, when there is market sensitivity—which unfortunately, the shadow Chancellor denies—if a rumour about a Monetary Policy Committee appointment meant that there was movement of the pound and the stock exchange. There is market sensitivity, so such appointments must be handled with care.

Gordon Brown: But her party supported it. The legislation that she supported provided for five internal members of the Bank of England and four external members. That was in the legislation. The Chancellor of the Exchequer was obliged to propose the appointment of people with experience and expertise to the Monetary Policy Committee. I ask the House whether the record of the Bank of England as a result of our decisions has been good or bad. In my view, the only answer that the House can give is that we have achieved a degree of stability that the Conservatives could never dream of.

Stephen Timms: I know my hon. Friend will agree that it is right for the estates of better-off people to contribute to wider welfare—and only 6 per cent. of estates paid inheritance tax last year. I think that he will also accept my point about the complexity that would arise if the threshold varied constantly, depending on what had happened to house prices, and if it were different in every area. In cases such as the one that he has described, equity release might help. I think that there would be a real problem if estates with no residential properties but otherwise identical paid different amounts of tax in different parts of the country.

Mr. Speaker: I can tell the hon. Gentleman that Tunbridge Wells is a bit too far away for him to get involved in this question. While I am on my feet, I must advise you, Mr. Stuart, that you must be quiet. You have had your say in the House, and it is unfair to barrack Ministers every time they speak.

Stephen Hesford: What steps his Department is taking to improve financial capability amongst the general public; and if he will make a statement.

Edward Balls: My hon. Friend is right. In implementing the pensions White Paper, we will need to focus on such capability issues for future pensioners as well as current pensioners. Some things have been done, and we have announced that financial education will be embedded in the GCSE maths curriculum over the new few years. But there is much more to be done, and I shall give the House two facts. On one hand, we know from our recent benchmark survey that more than 70 per cent. of schools provide personal financial education only occasionally—once or twice a month. We need to do much better than that, which is what the survey is about. However, our survey also shows that the cash management skills of many people on low incomes are very good—considerably better than the cash management skills of many people in the House.

David Tredinnick: Why has the Chancellor chosen to put this out with a whimper, not a fanfare, at the end of Treasury questions? Surely the House deserves a proper statement. And why is it so at variance with his press release of 19 July 2005, which promised a thorough review of demographic change, innovation, global issues and terrorism? What has happened to his pledge to look at spending over 10 years? If we just look at health spending, 73 per cent. has gone on increased costs. When will Government get a grip of these issues and ensure that money is spent more effectively?

Vincent Cable: I thank the Chancellor for sending us his 66-page report before the statement, but he did not give us the opportunity to respond fully to it. The Prime Minister himself set out the criteria at his party conference, when he stated that the report would describe
	"where we can save, and where we need to spend more".
	Since the Chancellor has already indicated where he intends to spend more—partly on admirable objectives such as reducing child poverty, but also on massive overruns on the NHS IT scheme, on an ID card scheme costing £15 billion, on acquiring sites for new nuclear power stations, and on advance spending on the Trident missile—can he point us to those paragraphs in the report that show the Departments that will be cut in order to accommodate that? Since his savings appear to depend largely on efficiency, which, of course we entirely welcome—the Gershon savings—can he point us to independent reviews that have shown where those efficiency savings have so far been materialised and how they will be monitored thoroughly in future?

Gordon Brown: We have had the work of the National Audit Office, the announcement in this document in relation to the first step—40,000 jobs in the Department for Work and Pensions and Her Majesty's Revenue and Customs that were referred to in the Gershon report have gone—and the announcement in this document that DWP, HMRC and the Treasury, as well as the Cabinet Office, will have 5 per cent. real-terms cuts in their budgets over the spending round. The hon. Gentleman has therefore got the answer that he sought. I also said that this is part of a process whereby, in the pre-Budget report, we will have the Varney report and further detail on departmental settlements. Next week, we will have the capability reviews of individual departments. That is a continuing process that will lead to the spending round next year. I thought that he would have welcomed that, particularly since he has a special problem to solve: he has to find £20 billion to plug the gap.
	When the leader of the hon. Gentleman's party was asked a few days ago how he would do that— [Interruption.]

Gordon Brown: Surplus land is a very good example—land that has been held by public authorities for a long period is now being released for housing. We have achieved £6 billion of asset sales in the last two years, and there will be £30 billion of asset sales by 2010. It would be wrong for the Government to hold on to assets that they did not need; it would be right for the Government to keep assets that they do need. My hon. Friend will see that that £30 billion makes possible investment in other areas of vital importance to the economy and to public services. He would be the first to acknowledge—indeed he did so—that in the last nine years we have doubled expenditure on health, and on education, and on policing and on transport, and the results are that not only do we now have more doctors, nurses, teachers and teaching assistants but standards in health, education and policing are rising, not falling.

Gordon Brown: I am pleased about those developments in my hon. Friend's constituency. That is happening in all constituencies, and Conservative and Liberal Members are also getting benefits from that investment. When we came into power net public investment was £7 billion. It is now £27 billion a year; it is rising, and because of the announcements today it will continue to rise every year right through to the end of the next spending round in 2011. I should have thought that in a country that desperately needs expenditure on infrastructure as well as investment in health and education, there ought to be all-party support for that increase in investment, rather than the cuts programme of the Conservative party.

Gordon Brown: What was un-implementable were the James proposals that the right hon. and learned Gentleman put forward at the last election. Our Gershon proposals have already achieved £9&frac12; billion out of the £21 billion of savings to be made by 2008. We have already reduced employment by the 40,000 net that we promised out of the 80,000 to come by 2008. We have already relocated 8,000 civil service jobs out of the 20,000 planned. We have reduced the share of administration in the Budget as proposed: compared with the 6 per cent. under the right hon. and learned Gentleman's Government, it is less than 4 per cent. under ours. I am not going to take any lectures about administration from the former Leader of the Opposition who was the poll tax Minister who caused the worst administrative mess in taxation this country has ever seen.

Gordon Brown: Sometimes I think that the hon. Gentleman lives in a completely unreal world. Identity cards are the policy of this Government. I should have thought that the more that people see the chances of their identity being stolen by organised crime, the more that they would support identity cards. The Opposition parties have made a very big mistake in opposing identity cards, which are part of the spending settlement for the Home Office.

Jack Straw: The business for next week will be as follows:
	Monday 17 July—Remaining stages of the Compensation Bill [ Lords].
	Tuesday 18 July—Consideration of Lords amendments to the Health Bill, followed by consideration of Lords amendments to the Government of Wales Bill, followed by a motion to take note of the outstanding reports of the Public Accounts Committee to which the Government have replied. Details will be given in the  Official Report.
	Wednesday 19 July—Opposition half-day [unallotted day]. There will be a debate on home information packs on an Opposition motion, followed by remaining stages of the Commissioner for Older People (Wales) Bill  [Lords].
	Thursday 20 July—A motion to approve the Terrorism Act 2000 (Proscribed Organisations) (Amendment) Order 2006, followed by a debate on international development on a motion for the Adjournment of the House.
	Friday 21 July—The House will not be sitting.
	The provisional business for the following week will be:
	Monday 24 July—Second Reading of the Welfare Reform Bill.
	Tuesday 25 July—Motion on the retirement of the Clerk of the House, followed by consideration of Lords amendments to the Northern Ireland (Miscellaneous Provisions) Bill, followed by a motion on the summer recess Adjournment.
	 The information regarding business on Tuesday18 July is as follows:—
	The following reports fall within the scope of the motion
	
		
			  2005-06 
			 Fourth Report Fraud and error in benefit expenditure HC 411  (Cm 6728) 
			 Seventh Report The use of operating theatres in the Northern Ireland Health and Personal Social Services HC 414  (Cm 6699) 
			 Eighth Report Navan Centre HC 415  (Cm 6699) 
			 Ninth Report Foot and Mouth Disease: applying the lessons HC 563  (Cm 6728) 
			 Twelfth Report Helping those in financial hardship: the running of the Social Fund HC 601  (Cm 6728) 
			 Thirteenth Report The Office of the Deputy Prime Minister: Tackling homelessness HC 653  (Cm 6743) 
			 Fourteenth Report Energywatch and Postwatch HC 654  (Cm 6743) 
			 Fifteenth Report HM Customs and Excise Standard Report 2003—04 HC 695  (Cm 6743) 
			 Sixteenth Report Home Office: Reducing vehicle crime HC 696  (Cm 6743) 
			 Seventeenth Report Achieving value for money in the delivery of public services HC 742  (Cm 6743) 
			 Eighteenth Report Department for Education and Skills: Improving school attendance in England HC 789  (Cm 6766) 
			 Nineteenth Report Department of Health: Tackling cancer: improving the patient journey HC 790  (Cm 6766) 
			 Twentieth Report The NHS Cancer Plan: a progress report HC 791  (Cm 6766) 
			 Twenty-first Report Skills for Life: Improving adult literacy and numeracy HC 792  (Cm 6766) 
			 Twenty-second Report Maintaining and improving Britain's railway stations HC 535  (Cm 6775) 
			 Twenty-third Report Filing of income tax self assessment returns HC 681  (Cm 6775) 
			 Twenty-fourth Report The BBC's White City 2 development HC 652  (Second Special Report, HC 1139, 2005-06) 
			 Twenty-fifth Report Securing strategic leadership in the learning and skills sector HC 602  (Cm 6775) 
			 Twenty-sixth Report Assessing and reporting military readiness HC 667  (Cm 6775) 
			 Twenty-seventh Report Lost in translation? Responding to the challenges of European law HC 590  (Cm 6775) 
			 Twenty-eighth Report Extending access to learning through technology: Ufi and the learndirect service HC 706  (Cm 6775) 
			 Twenty-ninth Report Excess Votes 2004—05 HC 916  (N/A) 
			 Thirtieth Report Excess Votes (Northern Ireland) 2004—05 HC 917  (N/A) 
			 Thirty-first Report Northern Ireland's Waste Management Strategy HC 741  (Cm 6843) 
			 Thirty-second Report Working with the voluntary sector HC 717  (Cm 6789) 
			 Thirty-third Report The Royal Parks and the Diana, Princess of Wales Memorial Fountain HC 644  (Cm 6789) 
			 Thirty-fourth Report Returning failed asylum applicants HC 620  (Cm 6863) 
			 Thirty-fifth Report The refinancing of the Norfolk and Norwich PFI Hospital HC 694  (Cm ????) 
			 Thirty-sixth Report Tackling the complexity of the benefits system HC 765  (Cm 6863) 
			 Thirty-seventh Report Inland Revenue Standard Report: New Tax Credits HC 782  (Cm 6863) 
			 Thirty-eighth Report Channel Tunnel Rail Link HC 727  (Cm 6863) 
			 Thirty-ninth Report Consular services to British nationals HC 813  (Cm 6863) 
			 Fortieth Report Environment Agency: Efficiency in water resource management HC 749 
			 Forty-first Report The South Eastern Passenger Rail Franchise HC 770 
			 Forty-second Report Enforcing competition in markets HC 841 
		
	
	The reference number of the Treasury minute to each report is printed in brackets after the HC printing number

Theresa May: I thank the Leader of the House for giving us the business up till the recess.
	There have been a number of oral statements in recent days but, sadly, that has not included the Chancellor's announcement about the fundamental savings review, and it was only because of your willingness, Mr. Speaker, to extend the time for Treasury questions that Members could question the Chancellor on that review. If the Chancellor has a statement to make, he should come to the House and make a proper oral statement, which would give a proper opportunity for all Members to question him on it. Perhaps his unwillingness to do so has more to do with the fact that the fundamental savings review was an idea announced by the Prime Minister at the Labour party conference, not by the Chancellor. Will the Leader of the House arrange for the Chancellor to come back to the House to make a proper oral statement on that review to allow more than just 20 minutes of questions from Members to the Chancellor?
	Oral statements enable Members to put questions direct to Ministers, whereas written statements do not give that opportunity to raise matters in the House, particularly if they are published on the day the House goes into recess. On the day the House went into recess at Easter, there were 39 written ministerial statements. Last year, on the day the House went into summer recess, there were 63 written ministerial statements. What steps is the right hon. Gentleman taking to ensure that we do not have a repeat performance, with a large number of written statements coming out too late for Members to question Ministers?
	It has been shown that there has been a hidden waiting list in the NHS for diagnostic tests, with patients waiting up to an average of 17 weeks for some tests. Some patients have to wait up to two years, but we do not know what the maximum wait is. Will the Leader of the House ensure that the Secretary of State for Health places full figures in the Library so that Members can see the true state of waiting lists, rather than the partial figures that the Government quote? Before the right hon. Gentleman prepares his standard response to me, which is about how many more nurses there are in my area, perhaps he will let me know instead why respite care at St. Mark's hospital, Maidenhead is under threat, Townlands hospital is under threat of closure and maternity services have been cut at Wycombe hospital—all affecting my constituents?
	It was shocking to read this week that the Department of Health has been sitting on a report on patient safety in mental health services that refers to a number of rape cases. May we have a debate on mental health services when we return in the autumn, and will the Leader of the House ensure that the Secretary of State for Health publishes that report well before the debate?
	Yesterday my right hon. Friend the Leader of the Opposition challenged the Prime Minister on reports that the ID card scheme had been delayed. The Prime Minister's response was:
	"It is a huge programme and there are bound to be changes along the way."—[ Official Report, 12 July 2006; Vol. 448,c. 1384.]
	So when will the Home Secretary come to the House to make a statement about those changes?
	The Home Secretary announced on 21 June that there were plans for a major shake-up of the Home Office and that his task force would produce firm proposals by July. Will the Leader of the House arrange also for the Home Secretary to come to the House before the recess to make a statement on the changes proposed for the Home Office, so that we can know what on earth is going on there? The Home Secretary gave himself 100 days to sort out the Home Office. He is more than two thirds of the way through, and with the visa scam at foreign language schools, failure to deport foreign criminals, the ID card project being delayed and confusion over police mergers, he is not doing very well.
	This summer the Office for National Statistics will bring in changes to place all private finance initiative deals on the Government's balance sheet. That is bad news for the Chancellor, as it could blow a hole through his sustainable investment rule. May we have a debate on the production and use of Government statistics? Does the Leader of the House stand by his comments made in a speech to the Royal Statistical Society in 1995 that there should be a national statistical service which should be
	"placed at arm's length to Ministers, on a similar basis to that of the National Audit Office, and should report principally to a powerful Committee of the Commons",
	and that the new arrangements
	"would be placed on a statutory basis within a 'Governance of Britain Act'"?
	Whatever happened to the governance of Britain Act?
	Finally, yesterday, when asked who would be in charge of the country in the Prime Minister's absence, the Prime Minister said that
	"the arrangements are exactly the same as they have been in previous years."—[ Official Report, 12 July 2006; Vol. 448,c. 1385.]
	Either that means the Deputy Prime Minister will be in charge or it means that, unbeknown to him, he has never actually been in charge in the past. It was reported at one stage that the Leader of the House was being put on stand-by to take over in the Prime Minister's absence. May I tell him that the country would breathe a collective sigh of relief if that happened? After all, he has a job, he owns his houses and he has never been seen wearing a Stetson. What are his holiday plans?

Jack Straw: It's the way she says it, Mr. Speaker.
	The right hon. Lady asks for a statement in relation to the spending review. It is standard procedure provided for in "Erskine May" for Secretaries of State answering questions that may generate much more interest than would be taken account of by the normal time allowance for questions to delay them till the end of the Question Time. That, in my experience, has generally been to the approbation of the House, so I am surprised that the right hon. Lady and other Opposition Members are being so churlish about it. Questions 4 and 14 were drawn down by my right hon. Friend the Chancellor of the Exchequer precisely because he recognised the interest in the matter, and there were then well over 20 minutes to discuss it.
	The right hon. Lady spoke about oral statements. I entirely accept that, wherever possible, it is better for oral statements rather than written statements to be made to the House, and we will not keep her unsatisfied in that respect this week, next week or the week after. However, many statements have to be made by way of written ministerial statements. It is a characteristic of all Governments at all times that many announcements tend to be delayed until the last minute before recesses. Written ministerial statements was an innovation that we introduced because they are better than planted parliamentary questions, but I am encouraging my colleagues to ensure that whenever possible written ministerial statements are published before the last day. We are all aware of the issue, but with the best will in the world, there will be some on the last day.
	The right hon. Lady asked about hidden waiting lists and the true state of those lists. I am only too happy to tell her about the true state of the waiting lists. I will not mention the increase of 85,000 in the number of nurses since 1997, nor the increase of many thousands in the number of doctors. Nor will I mention the fact that between 1997 and 2005 the number of doctors in the health area that covers the right hon. Lady's constituency increased by 1,400. I will mention, however, that overall waiting lists have fallen by 370,000 over the past nine years. The average wait for in-patient treatment is now 7.7 weeks, and waits of more than nine months are down by more than 118,000 since 1997. I am grateful to the right hon. Lady for asking that question.
	I understand the point that the right hon. Lady makes about mental health services. My right hon. Friend the Secretary of State for Health is ready to publish the National Patient Safety Agency's report, which is being finalised, as soon as it is complete. I cannot promise that there will be a debate on mental health services in the spillover session, but I can promise that there should be such a debate in the autumn.
	The right hon. Lady asked about statements by my right hon. Friend the Home Secretary. There will indeed be statements if he has to make any significant changes before the recess.
	The right hon. Lady referred to a fine speech that I made in 1995 about reorganisation of the Office for National Statistics. I am flattered that she has such a stock of my speeches. That led to a manifesto commitment in 1997, which my right hon. Friend the Chancellor of the Exchequer has taken forward. Progressively, we have strengthened the independence of the ONS—I am glad to see agreement from Conservative Members on this—and we will continue to do so. That is in sharp contrast to the scandal under the Conservatives, who undermined the integrity of national statistics by manipulating them.
	I am surprised that the right hon. Lady did not give me the usual list of demands for additional debates. I assume that she did not do so because of the most extraordinary own goal that she and Opposition Front Benchers committed yesterday. I have been in this House for 27 years, and I cannot think of a single occasion when the Opposition have gone into the Lobby five minutes before an Opposition day debate to vote to silence the House on that day. However, if they want to carry on in that way, that is absolutely fine.

Jack Straw: Let me deal first with the hon. Gentleman's point about the drawing down of Questions 4 and 14 by my right hon. Friend the Chancellor of the Exchequer. There is nothing unusual about this procedure. [ Interruption.] There is not—it is set out on page 399 of "Erskine May", and it is usually for the convenience of the House. I used the procedure as Foreign Secretary in respect of an issue that was of profound importance to Members of this House, as well as internationally, and excited just as much interest—the necessary withdrawal of our monitors from the jail in Jericho that then led to the arrests of the prisoners. For the life of me, I cannot see why Opposition Members are complaining about this, because it was to the benefit of the House, not its disadvantage.
	I cannot guarantee that there will be no written ministerial statements on the Tuesday that we get up, but I hope that there will be fewer. As we all know, when written ministerial statements are put down on the Tuesday rather than the Monday there is, among other things, a cry that we are trying to avoid scrutiny. Generally speaking, we are not—it is merely that there has been a great logjam in getting them agreed.
	There will be a debate on aspects of the health service when the Compensation Bill is before the House on Monday. There are plenty of opportunities to debate health services, and we are always delighted to do so, because despite the difficulties that will arise at any time, there is not a single constituency in which health care and spending has not improved, and the satisfaction of our constituents has not gone up, in the past nine years. Yes, it is the duty of Oppositions to criticise the Government, but in doing so they should not continually imply criticism of the additional thousands of doctors, nurses and other health care workers who are delivering that additional health care.
	The hon. Gentleman will be aware that Sir Hayden Phillips is conducting an inquiry into party funding to which all parties are giving evidence. Sir Hayden has said that he intends to report by the end of the year, and he may give some interim indications in the middle of the autumn. It would be premature to have a debate until we have at least an interim report from him.
	On the Scrutiny Committee, I hope that the hon. Gentleman will allow me to write to him.

Peter Soulsby: In response to questions from me at a sitting of the Environment, Food and Rural Affairs Committee yesterday, the Secretary of State was unable to reassure the Committee that, as a result of failures in the Rural Payments Agency, the Department is not contemplating severe cuts in current and future budgets of the agencies and organisations that it funds. Will the Leader of the House give an assurance that, if DEFRA is contemplating cuts to bodies such as the Environment Agency and British Waterways, he will ask the Secretary of State to come to the House to make a statement before the recess so that hon. Members have the opportunity to question him about why those bodies, their customers and those who rely on their services should suffer cuts because of unconnected failures in the Rural Payments Agency?

Jack Straw: I understand the desire for a full debate, and so does my right hon. Friend the Foreign Secretary. My right hon. Friend the Prime Minister will go to St. Petersburg for the G8. As he told the Cabinet today, it is clear that the deteriorating situation, which now affects the whole middle east, will be at the top of the agenda for all G8 countries. In Cabinet, my right hon. Friends the Foreign Secretary and the Prime Minister expressed profound concern, and the Foreign Secretary reminded Cabinet of her condemnation of what is regarded as a disproportionate response by Israel as well as deep concern about the activities of Hamas and Hezbollah.
	My right hon. Friend the Prime Minister will make a statement about that on Tuesday, following his return from the G8. The statement will be about the whole issue of the G8, but this matter can be covered by him in that statement, and it will be. There are also Foreign and Commonwealth Office questions in the following week, and meanwhile my right hon. Friend the Foreign Secretary will be at the General Affairs and External Relations Council of the European Union on Monday, where this matter will be top of the agenda—and, if possible, she or one of her Foreign Office Ministers will make a statement later in the week, if necessary.

Jack Straw: The progress of Bills in this House is a well-known procedure, and the Government will of course respond to the Public Administration Committee in due course.

Tom Harris: I draw my right hon. Friend's attention to early-day motion 2519:
	 [That this House believes plans by the right hon. Member for Witney to ban hon. Members representing constituencies in Scotland from voting on matters relating exclusively to England would precipitate a constitutional crisis which would threaten the future of the United Kingdom; and further believes that everyone elected to this House should have the same rights of participation, irrespective of which part of the United Kingdom they represent.]
	I tabled it in anticipation of the expected Opposition day debate by the Conservative party on the West Lothian question that was due to take place yesterday, but which did not do so, presumably because wiser counsel from the right hon. and learned Member for Kensington and Chelsea (Sir Malcolm Rifkind), the hon. Member for Woodspring (Dr. Fox) and—God help us—the  Daily Mail prevailed. Therefore, may we have a debate in Government time on the West Lothian question, so that the Conservative party's incredibly cynical position on this issue can be properly exposed?

Geraldine Smith: I am sure that the Leader of the House appreciates the importance of schoolchildren being able to visit this House, and that he will be delighted to know that a group from Morecambe high school are down here today, seeing the workings of Parliament. Will he join me in thanking the education unit for all its help, and, indeed, Virgin Trains for making it possible for schoolchildren from the north-west to come here? However, can he also tell me what we can do to improve facilities—and, indeed, when the visitors' centre will be ready—so that we can make the public outside most welcome in this House?

Hilary Benn: With permission, Mr. Speaker, I wish to make a statement about the White Paper on International Development that I am publishing today. Copies of it, and of this statement, have been placed in the Vote Office.
	At a time when the world has never been richer in wealth and knowledge, pregnancy and child birth claim the life of a woman every minute. Every day, dirty water and bad sanitation claim the lives of 5,000 children. Every year, malaria kills 1 million people, tuberculosis 2 million people, and AIDS 3 million people. Each death is a death caused by poverty.
	Last year, the world came together and agreed to do something to change that. The G8 summit at Gleneagles promised more aid and debt cancellation, support for free education and health care, treatment for all with HIV/AIDS, and better ways of dealing with conflict. We have made progress in the past 12 months, but we have not yet made poverty history. There is still much to do, and this White Paper sets out our plans for the next five years. In preparing it, we received more than 600 submissions from around the world, and I would like to thank Members and their constituents, as well as many others, for their contributions.
	How countries progress and improve the lives of their citizens is a complex process, but we know that governance is fundamental to it. Development does not happen without effective states that are capable of delivering services to their citizens and helping economies to grow—states that respond to people's needs and which, in turn, can be held to account. For all those reasons, good governance is at the heart of this White Paper.
	While we will continue to help build public institutions' capacity for good governance in developing countries, we will now do more at the grass roots to reinforce the demand for good governance. To do this, we will set up a new £100 million governance and transparency fund, which will support civil society, a free media, parliamentarians and trade unions in improving accountability. To ensure that our aid is used to best effect, we will in future regularly assess the quality of governance and transparency and the commitment to reducing poverty in the countries in which we work. We will publish these assessments and use them to help make decisions about our aid.
	Recognising that bad governance and corruption are international problems, too, we will: publish an annual UK action plan to tackle corruption affecting developing countries, and report on progress every six months; set up a new unit to investigate money laundering and allegations of bribery affecting UK firms; help developing countries to track assets and to carry out investigations; seek to expand—including through a resolution in the United Nations General Assembly—the successful extractive industries transparency initiative to other sectors such as construction, procurement and health; and work with others to set international standards to tackle the trade in conflict resources that fuels so much destruction.We will also strengthen implementation of the Organisation for Economic Co-operation and Development's guidelines with new arrangements for the UK contact point, involving independent experts.
	People cannot escape poverty if there is war and insecurity. We will therefore increase our efforts in fragile states and invest more in at least 10 countries where security is a major issue. That will mean help with reintegrating ex-combatants, supporting access to justice, monitoring human rights and reducing the spread of small arms, including through an international arms trade treaty.
	Peace and good governance are also essential for the economic growth needed to create jobs and raise incomes. We will support the Infrastructure Consortium for Africa—which has already helped to secure investment of £1.4 billion in a range of projects—and the investment climate facility. We will double our funding for research in science and technology, agriculture, adapting to climate change and new drugs and vaccines. We will help poor people to get better access to markets to sell their goods, and to finance to support their livelihoods. We will also continue to press for a trade round that enables developing countries to earn their way out of poverty, while meeting our pledge to provide £100 million a year in aid for trade by 2010.
	Everyone should have decent health care, education, water and sanitation, and social security when times are hard, and UK aid is already helping Governments to bring those to more of their citizens. With our aid rising to meet the UN 0.7 per cent. target by 2013, we will increase our spending on these public services to at least half of our bilateral aid budget. We will make long-term-commitments through 10-year plans, so that countries can make long-term decisions to hire staff, build schools and clinics and abolish user fees.
	We will increase spending on education to £1 billion a year by 2010 and, having doubled our spending on water and sanitation in Africa to £95 million a year by 2007, we will double it again by 2010, because clean water saves lives and helps more girls to go to school. We will also significantly increase our spending on social security in at least 10 countries in Asia and Africa over the next three years, because we know that one of the most effective ways to break the cycle of destitution that affects the poorest and most vulnerable is to give them a hand up to get them back on their feet.
	All that will need to be done in a world that is changing—in which there is population growth, rapid urbanisation, the depletion of natural resources and climate change. That will be the ultimate test of global good governance, so we will work to secure international agreement on a long-term stabilisation goal; seek to ensure that developing countries are able fully to participate in any international negotiations; and support countries in adapting to climate change while generating the investment needed for clean energy.
	We will also need an international development system fit for this century, not the last. We will push for reform of the United Nations, so that there is centrally pooled funding and a single plan in each country; an integrated UN humanitarian system that responds faster when crisis strikes; further reform of European aid, so that the European Union can play its full part in international development; and a better system for holding all of us—developed and developing countries alike—to account for the promises that we have made.
	Finally, because this is a task for all of us, but particularly for the next generation, we will double our investment in development education so that every child in the UK has a chance to learn about the issues that shape their world. We will set up a new scheme to help UK groups to build links with developing countries and expand opportunities for our young people and diaspora communities to volunteer in those countries and to undertake internships with development charities.
	Madam Deputy Speaker, there is much for all of us to do. We have listened to the voices of people in developing countries, who have told us all what they want. We listened to the British people as they campaigned to make poverty history and, with their and the House's support and the proposals I am setting out today, the UK will play its part in helping people to eliminate poverty and to change their lives, and thus our world, for the better.

Hilary Benn: I am grateful to the hon. Gentleman for his work in chairing the International Development Committee and for his kind words. In the case of Ethiopia, we have found another route for our aid, through the basic services grant, so that poor people are not punished because of the problems of governance there. In Uganda, a political settlement is needed. In my view, that requires the five indicted leaders of the Lord's Resistance Army to be hauled off to the International Criminal Court where they belong, because that would unlock an end to the terrible crisis that has affected so many people there.
	The head count restrictions will have an impact on the way in which we work. The permanent secretary is also looking at how we are going to make that happen. I know that he gave evidence to the Select Committee the other day. As far as the multilateral system is concerned, we will become more selective about where we put our money. The question that I will increasingly ask—as the House would wish—is, "What effect will we get from putting our money into this route, as opposed to that one?"
	I look forward with great interest to the private sector development report. Good governance is fundamental to unlocking the investment that the hon. Gentleman and I want to see. If there is peace, security, stability and good governance, people are much more likely to invest their own money and that of other people.

Madam Deputy Speaker: Order. I remind hon. Members that there is a further statement to follow, as well as the main business. I therefore request that Members ask just one supplementary question, and that the Minister give just a brief reply. In that way, as many people as possible will be able to catch my eye.

Tony Baldry: The New Partnership for Africa's Development—NEPAD—was meant to be a compact in which we gave more money and aid and African countries enhanced their governance. What is the Secretary of State's assessment of the progress of the NEPAD initiative? He rightly referred to the importance of parliamentarians, and the civil capacity fund for Africa is obviously very good news. However, is there not also work there for the Commonwealth Parliamentary Association? As we went through Africa, those of us who were on the Select Committee in the previous Parliament found—as I am sure those on the present Committee will—that parliamentarians were often getting left out of civil society. Their capacity seriously needs enhancing.

Hilary Benn: NEPAD has made progress most of all in relation to the peer reviews. A couple of them have now been published and those of other countries are coming through the system. In the end, people will judge how effectively the results of those reviews are implemented. I specifically mentioned parliamentarians in relation to the governance and transparency fund because I agree with the hon. Gentleman that parliamentarians play a very important part in holding Governments to account. We will therefore look into how the fund can work to support them.

Hilary Benn: One of the legacies of badly given aid is that donors turned up and built schools and clinics, and went away and said, "Hey, we have brought something good to the community." However, there was never any connection to the capacity of the Government of that country to fund and put in staff to maintain the buildings. In the right circumstances, therefore, the best approach is to work with Governments to build their capacity so that they can plan on the basis not only that they will build the school but that they have the money to employ the teachers, do the maintenance, provide the supplies and make sure that the children get educated.

Henry Bellingham: Zimbabwe was once a great African country with a first-class agricultural system. It has now become a total disaster, with an evil corrupt dictatorship not just persecuting its poorest people but regularly stealing aid money. How can Britain and Europe make sure that the starving, helpless and poor of Zimbabwe are helped without further bolstering the Swiss bank accounts of Mugabe and his henchmen?

Laurence Robertson: I am sure the Secretary of State will agree that Africa possesses incredible tourist attractions in its history and natural beauty, yet fails to realise its assets. That is partly because of poor facilities—poor transport, for instance—but also because of the negative messages that emerge from African countries. People do not think that they should visit Africa, and they do not know what they are missing. What can the Government do to help those countries promote tourism in their areas?

Hilary Benn: With respect, we do not double count debt cancellation as aid expenditure. The Development Assistance Committee of the Organisation for Economic Co-operation and Development does the counting. It produces the overall figures and identifies aid and debt cancellation separately.
	I resolutely reject the argument that debt cancellation does not help. Why will Nigeria be able to send another 3.5 million children to school? Because it has benefited from the biggest single debt deal in African history. Why has Zambia been able to introduce free primary health care in rural areas? Because of aid and debt cancellation.
	I do not accept the hon. Gentleman's argument at all. We will continue to give help through both aid and debt cancellation.

Vera Baird: With permission, I wish to make a statement about the publication of Lord Carter of Coles's Review of Legal Aid Procurement, following a statement by my noble Friend the Lord Chancellor and Secretary of State for Constitutional Affairs in the other place earlier today. Copies of Lord Carter's review have been placed in the Printed Paper Office, the Vote Office and the Libraries of both Houses. A joint consultation paper on his proposals has been issued simultaneously by the Department for Constitutional Affairs and the Legal Services Commission, copies of which have also been placed in the Printed Paper Office, the Vote Office and the Libraries.
	Lord Carter's report is the product of a year of engagement between a number of stakeholders. Government, the Legal Services Commission, the Law Society, the Bar Council and the judiciary, individual practitioners and others all played a full part in the discussions that led to his recommendations.
	In his report, Lord Carter identified the importance of publicly funded legal services to ensuring proper access to justice for those in need of advice and representation, and for those who are charged with criminal offences. He rightly refers to the high quality of our legal system.
	At a time of finite public resources and ever-increasing pressure on the legal system, it is vital that we review our arrangements for the provision of legal aid. For some time, under successive Governments, they have not fully served either the public or the clients of the system. Changing the way in which we purchase legal advice services is a key element of our desire to reform the criminal justice system and provide better outcomes in civil and family justice. I know from experience the difficulty of balancing all the competing factors to ensure that legal aid is fair to the vulnerable, fair to taxpayers, fair to defendants and fair to practitioners.
	Lord Carter concluded that there must be a fundamental change in the way in which legal aid services are procured, so that clients have access to good-quality legal advice and representation, so that a good-quality, efficient supplier base thrives and remains sustainable, so that the taxpayer and the Government receive value for money, and so that the justice system is more efficient, effective and simple. He recommends a new system for the provision of criminal legal aid in which the professions ensure proper quality control over their members and lawyers are as far as possible paid on the basis of completion of a case rather than according to the number of hours for which they have worked, and are encouraged to be as efficient as possible by being able to compete for work on the basis of price.
	Lord Carter proposes that the criminal legal aid market should be restructured and suggests a timetable. April 2007 should see the introduction of a new fixed fee scheme in police stations. It should also see changes to standard fees for magistrates court cases, changes to the advocates' graduated fee scheme in the Crown Court and an extension of the graduated-fee scheme to litigators in the Crown Court. For very high-cost cases, the Legal Services Commission should introduce an enhanced quality threshold and use a higher level of in-house expertise and closer management to secure greater control over the individual case contracting regime. Lord Carter proposes that that be achieved by the end of the financial year 2007-08 through the LSC contracting solely with a panel of suppliers. Panel membership would be determined through demonstration of an appropriate enhanced level of quality, as well as through competition. Price competition should be introduced in 2009, with quality assured suppliers bidding for multiple units of cases in police stations which they would usually take to the magistrates courts and/or Crown Courts.
	The transition to a more market-based approach comes alongside changes to the regulation of legal services, as outlined in the draft Legal Services Bill. Taken together, those developments will mean change for the profession—a degree of restructuring for solicitors and barristers alike. The changes must be managed in a way that ensures continuing quality and choice for the public, while giving the professions time and, if necessary, support to adjust to the new model.
	Lord Carter recognises the need to ensure that providers of legal services continue to serve black and minority ethnic communities and those in less densely populated and rural areas. He strongly acknowledges that one size does not fit all, and makes detailed proposals to ensure the continued improved provision of high-quality legal services for all those communities. His report contains detailed recommendations that will help us to devise the criminal justice system that the public expect: one that is simple and speedy, and makes the best use of summary justice.
	For civil and family legal aid, the report provides for a more efficient, client-focused service, concentrating on meeting different local needs. Lord Carter suggests that that will be achieved through the establishment of community legal advice centres and community legal advice networks, which is in line with the Legal Services Commission's strategy for community legal services. Best value tendering for the new centres and participation in the networks should begin in 2009.
	New forms of contracting are expected to promote greater links between civil suppliers and, where possible, greater links with family law suppliers, so that clusters of problems can be dealt with earlier and more effectively to avoid the risk that they multiply and lead to people falling into the social exclusion trap.
	The Legal Services Commission also proposes to move to fixed and graduated fees from April 2007 for a wide variety of civil and family work, and also for most immigration work. That will promote and reward the most effective working by suppliers. The consultation document published alongside Lord Carter's report contains full details.
	Lord Carter estimates that if the reforms had been fully in place in 2005-06, criminal legal aid spending would have been £100 million lower, and that does not take account of the potential further savings from best value tendering. In addition, there would have been a greater proportion of legal aid spent on civil and family matters. By the end of the implementation period, because the reforms will also control unit costs far better than many elements of the current scheme, spending will be lower than it would be without the changes proposed. I also welcome and accept Lord Carter's recommendation for better management and control of spending, including through greater transparency and shared problem-solving between the DCA, the LSC, other Departments and the professions.
	In conclusion, the Government strongly welcome Lord Carter's findings and we have today issued a consultation paper to which I encourage everyone to respond. I look forward to the challenges that are ahead and working with all stakeholders and the Legal Services Commission, the dedication and commitment of whose commissioners and staff will be critical to success. I am immensely grateful to Lord Carter for the work that he has done.

Oliver Heald: I am grateful to the Under-Secretary for her courtesy in giving the Opposition early sight of her statement today, and I thank Lord Carter for his meeting with me. We welcome the publication of the report, and will study the proposals in detail. We hope that it will spark a debate that can provide the basis for a consensus on reform of the legal aid system that is built to last.
	Legal aid remains the cornerstone of our criminal justice system, providing access to justice for millions of people, but today it is in crisis. In 1997, the Government promised to reform legal aid in order to
	"achieve value for money for the taxpayer and the consumer".
	Instead, we have seen a 35 per cent rise in the overall legal aid budget, while at the same time spending on civil legal aid, excluding asylum, is down by a quarter. That in turn is damaging access to justice for many of the most vulnerable people in society. So we all agree that reform is necessary.
	We endorse Lord Carter's emphasis on the need to tackle very high cost cases, which account for around half of current criminal legal aid budget. In that context will the Under-Secretary tell us what steps the Crown Prosecution Service, the Serious Fraud Office, Her Majesty's Revenue and Customs and the British Transport police intend to take in order to respond to the challenge of managing the prosecution of cases more efficiently and effectively? Does she agree that in addition to the measures proposed by
	Lord Carter, more effective case management by courts is essential if costs are to be kept down?
	Much is made of the fees earned by barristers at the top end of the scale in very high cost cases, but the Under-Secretary will be aware of the concerns among barristers and solicitors about many more in the profession who rely on legal aid work, yet who barely earn enough to get by. Does she accept that that has already resulted in fewer lawyers choosing publicly funded legal aid work as a career, which in turn is placing huge strains on the civil legal aid system? The Under-Secretary will know that the Bar Council is concerned by the further delays before help is provided for those doing those shorter cases. The London Criminal Courts Solicitors' Association has said today that Lord Carter's proposals:
	"will stop the recruitment of able and passionate solicitors to this area of legal practice".
	How does the Under-Secretary respond to such concerns?
	There are other parts of the statement, and Lord Carter's report, that give rise to concerns—in particular, the likely impact on the network of high street solicitors and law centres, such as the one that I visited in Tower Hamlets recently. In particular, will the Under-Secretary respond to the fears expressed by many that Lord Carter's proposals on procurement sound the death knell for small high street solicitors undertaking legal aid work? This morning, the vice-president of the London Criminal Courts Solicitors' Association said that the proposals were:
	"an enormously bureaucratic and costly re-organisation of the supplier base which is the high street solicitor that will lead, perhaps, to many of them closing".
	What steps do the Government intend to take to deal with those concerns and to allay fears that advice deserts will emerge?
	Page 52 of Lord Carter's report refers to the needs of vulnerable black and ethnic minority clients. She will be aware that many small high street solicitors tailor their services to the needs of black and ethnic minority clients. However, under Lord Carter's plans, those are precisely the types of firm that risk being squeezed out of the system and, in the process, significant role models of success in the legal world for minorities will be lost. Does she agree with the Criminal Law Solicitors' Association which has said that such firms will be "disproportionately disadvantaged" by Lord Carter's plans?
	Finally, the Minister referred to the publication of a consultation paper on Lord Carter's report. Will the Under-Secretary confirm, therefore, that valuable as his report is, it does not represent the final word, that there is some scope to refine his plans and that the Government will address the genuine concerns of many in the legal profession who want a system that combines both value for money and proper access to justice?

Vera Baird: I thank the hon. Gentleman for his welcome for the report and his hope, which I share, that it will spark a debate on those important issues. I agree wholly that we need to build a system that will last. The increase in legal aid expenditure since 1997, to which he alluded, is not an isolated example. This morning, I looked at the tables in the fundamental legal aid review document, which show that spending also went up exponentially between 1991 and 1996, so it is clear that successive Governments have not managed to control that elusive budget.
	The hon. Gentleman raises the issue of very high cost cases, and I urge him to read with care—I accept entirely that he has not had the slightest opportunity to do so—what Lord Carter proposes for closer management of such cases, with a higher level of expertise in the LSC to ensure that they are controlled as well as they can be. I accept entirely the hon. Gentleman's point that all that cannot be done through legal aid alone: there is a serious need for the CPS and the other public agencies he mentioned to consider case management. The Carter review contains a quotation from Sir Igor Judge which gives the judicial attitude to the urgent need for powerful case management. The judiciary are anxious that judges should be free to do that, and of course we entirely encourage it. We are seeking, with the consultation document that will build on Lord Carter's report, to use the new fixed fee regime that he proposes to try to enhance the ability of the judiciary to manage cases properly.
	The hon. Gentleman also referred to the frequently expressed criticism of fat cat barristers who earn enormous amounts of money. I have never been fat myself —[ Interruption. ] Neither metaphorically, nor physically, but I am not sure that the House is interested in that. There is some interesting information about lower level members of the Bar in Lord Carter's review. He found that 5 per cent. of those with between one and five years' experience at the Bar were earning £90,000 a year. That seems to be a fine starting salary, although many others do not earn that much. However, that is an issue for those who structure the Bar, and not one that legal aid can tackle directly.
	I accept that the Bar Council would prefer not to delay the catch-up that it thinks should follow from the fact that graduated fee schemes for one to 10-day cases were fixed in 1997. However, a letter from the council this morning states that, as a result of its negotiations with Lord Carter, it acknowledges that process should occur from 2007.
	I do not agree with the hon. Member for North-East Hertfordshire (Mr. Heald) that the London Criminal Court Solicitors' Association is right to suggest that the proposals will end recruitment to the public sector. Not a bit of it: he was present at the recent Legal Aid Practitioners Group awards for legal aid lawyer of the year and, like me, can only have been impressed by the calibre of the many excellent young practitioners there. They are fighters, every one of them—much of the time they are fighting us!—and they are coming into the public sector, so I do not think that what the hon. Gentleman said is right.
	I do not agree either that we are about to hear the death knell of high street solicitors. Much concern was aroused by the interim report, which did us all a huge favour by making us refine our thinking. The process of implementation will need a great deal of consultation and care. It is proposed that I should spend a sizeable part of my summer going around and providing exactly that, although of course people will also be able to correspond about other matters.
	I heard Greg Powell say on the radio this morning that he thought that the proposals would involve a huge amount of bureaucracy, but the LSC is looking to make savings in that regard worth tens of millions of pounds. It is anxious to have a lighter touch, and of course practitioners want to escape from bureaucracy. The whole point of having fixed fees at the front end of cases across the board is so that there will be no thorny questions about whether a particular mention, application in court or piece of travel and waiting was justified. It seems to me that the fixed fee will mean less bureaucracy.
	The hon. Gentleman talked about black and minority ethnic practitioners and communities. The LSC can and must use its procurement power to ensure that those communities continue to be served fully and properly by appropriate practitioners. I do not accept that practitioners from the black and ethnic minorities will be squeezed out. Lord Carter received legal advice suggesting that no inappropriately heavy burden would fall on them, but I know that serious concerns have been expressed about that.
	I had the pleasure of speaking to the annual conference of the Black Solicitors Network, and I took the opportunity to talk to a number of its members. The network represents a very important and dynamic sector of young black entrepreneurs, and we must take good care of them. I assure the House that we are very much apprised of the need to ensure that they have appropriate career opportunities.
	I can confirm that the report is not the last word on the matter. Lord Carter undertook a very good consultation process that involved all the relevant stakeholders. I know that he spoke to the hon. Member for North-East Hertfordshire, and I believe that he spoke to the Liberal Democrats as well. The confidence that the process has given us means that we are able to take on Lord Carter's direction of travel, as it were, but with a clear awareness that there is still a good deal of scope for policy development during the consultation that is to follow.

Fiona Mactaggart: I thank my hon. and learned Friend for her statement, and welcome her to her post. I am concerned about accountability in how neighbourhoods provide advice and representation, on legal matters and on issues that at least at first may not involve the law. In my constituency, partly as a result of the behaviour of the local authority, there is a real shortage of competent advice on debt, immigration and other matters. I have not read the report, but will she clarify what accountability mechanism will be put in place to make sure that advice is provided in a neighbourhood? Does it all come down to the LSC, or is there some way for us to ensure that the local authority or some other body can take responsibility for providing advice in a particular community?

David Heath: I thank the hon. and learned Lady for her statement, and Lord Carter for his work on the review. I also commend the process so far, which has involved an extremely good level of consultation. I am heartened by the Minister's earlier confirmation that the further consultation process will be genuine, and that comments will be welcomed and taken on board.
	The importance of legal aid is worth underlining yet again. It is a key part of the welfare state, although we probably talk about it less than any other. The squeeze on legal aid budgets over recent years is not the result of inefficiencies in the system: it is largely due to the increase in business caused by the wide panoply of new offences and the increased number of prosecutions taking place. That is what is driving the increase in criminal aid, which in turn has squeezed the availability for legal aid in the civil and family courts.
	The squeeze on legal aid is causing great concern, as access to legal aid is an essential part of a fair and free society. I hope that all hon. Members will agree with that, and that the report's proposals will increase access to legal aid.
	The Minister said that she felt there would be no deterioration in the position of high street practitioners. I hope that she is right, but legal aid in the more rural areas—and in some cities too—is in a parlous state, with those practitioners who offer criminal legal aid, for instance, being very few and far between. For instance, it is common for there to be only one criminal solicitor available to deal with a particular magistrates court. We therefore have to do something to encourage more practices to release practitioners to do criminal legal aid and to undertake work in the family courts.
	I have a few quick questions for the Minister. First, she was right to emphasise the need for better organisation in our courts, and one factor in that is the court's proximity to the people attending it. Travel to court is a key part of the costs incurred by practitioners, defendants, witnesses and victims. Centralising court facilities leads to an apparent cost saving, but there is a real cost to the people seeking justice. The two need to be in balance, as justice is being taken away from people in many rural communities because courts are being closed down.
	Will the Minister ensure that the financial incentives to finish cases quickly do not prejudice the standard of justice in courts? That is an obvious point but it is terribly important so it is necessary to make it.
	Will the Government guarantee that defendants can be represented by the same good local lawyer from the beginning to the end of proceedings? That may or may not be implicit in the arrangements as they develop.
	Can we make sure that lawyers undertaking publicly funded work have sufficient recompense to attract them to such posts rather than going into private practice? The hon. and learned Lady may have partly answered that question already.
	Lastly, to pick up the point made by the hon. Member for Slough (Fiona Mactaggart), a process of audit of advice and legal services is needed and Members of Parliament have a critical part to play in it. Often, advice deserts are not in the most deprived communities. The worst thing of all is to be a poor person in a rich community, who does not have access to transport and to high-cost support and will be very much excluded if we are not careful. The hon. and learned Lady's Department needs to work closely with the Minister for Social Exclusion to ensure that a proper audit system is in place. MPs could play a useful part in that process, so will she consider that?

Vera Baird: Indeed.
	A point was put to me about the demise of high street solicitors. I cannot say that they will be unaffected by the review, but Lord Carter's proposals do not mean a big is beautiful situation; they are about tuning the new system to ensure that efficient suppliers of a variety of sizes and structures who have been satisfactorily peer-reviewed—I cannot emphasise enough the point that quality is up-front in Lord Carter's proposals—ought to be able to succeed under the best tendering model. So, as I said, high street solicitors will not be unaffected but there is no reason to forecast their demise.
	The hon. Gentleman referred to local courts and accepted the need for a balance. Of course, local justice can be good justice but appropriate facilities are needed, too. Some local court buildings are very old indeed and cannot accommodate modern needs; not only for disabled access, but also for defence witnesses to be kept away from prosecution witnesses and so on. Various moves are afoot. Last Friday, I had the pleasure of visiting the Liverpool community justice project, in which justice simply could not be more local. The project is having a superb impact because it is so well knitted into the surrounding community. Such initiatives are to be praised and encouraged. As ever, we are trying to do everything at once.
	The hon. Gentleman asked that financial incentives should not compromise cases and that the need to fix fees would not undermine a decent pay rate for lawyers. I think that was implicit in what I said. There is no intention to do that; it is everyone's intention that good quality lawyers should continue to be recruited to the public sector. Our courts simply cannot work without them—the hon. Gentleman can rely on that.
	The hon. Gentleman asked whether a defendant could be represented throughout the proceedings by a good local lawyer. Solicitors will bid for a quantity of police station cases, and the usual model would be that they would take the case through from the police station to the magistrates court and to the Crown Court, if appropriate. There is provision in Lord Carter's recommendations, which I applaud, for consultation on own-client work; that is, somebody who comes under the duty rota scheme by virtue of being locked up at a particular police station but who has another solicitor elsewhere with whom he has some faith. If he were able to rely on that person it could assist the system. There is scope for consideration of such ideas, but the broad intention is that the person who picks up the case at the police station should take it all the way through. High-cost cases are the exception. It is proposed that a panel of experts be set up and when it is clear at the police station that the case is a specialist one, it would go directly—as an escape route—to the panel.
	I agree entirely that although it is bad to be poor in a poor area, it is just as bad to be poor in a rich area. The hon. Gentleman will have appreciated from my previous answers that I am very engaged in how advice can assist in dealing with social exclusion. As he understands, a major thrust of the legal aid review is the intention to move money, where and when possible, over to civil sectors so that people can be prevented from going into social exclusion by timely advice about their problems in the first place.

Alan Whitehead: I too thank my hon. and learned Friend for her statement. What impact does she consider that Lord Carter's proposals will have on the development and regulation of the no win, no fee system? Is it her intention, during the consultation period she has mentioned, to consider those impacts and the regulation of the system outside the legal aid process?

Vera Baird: I sympathise with my hon. Friend's comments. There was of course auditing of advice by the community legal service partnerships when they were set up, but I think he is right; not only is there a multiplicity of agencies but there is also a large number of core lines of one sort or other that give advice on debt, housing or consumer affairs. They are lodged in various Departments of Government—the Department of Trade and Industry, the Department for Work and Pensions, the Department for Education and Skills and our own Department. Clearly, the expertise for coordinating the availability of such advice probably lies with the Legal Services Commission, and yes, it is imperative that they are consolidated so that they work in a coherent way, without duplication, and provide an adequate service.

Si�n Simon: I beg to move, That the clause be read a Second time.
	I am delighted to move the motion, and I declare an interest as a trustee of AvMAaction against medical accidentsthe leading patient safety charity in this country. I speak to the new clause as a Member of Parliament and not on behalf of that organisation, with which I cannot and do not formally speak. However, I know that, like me, AvMA is grateful to the Minister for having listened to our concerns and those of patients across the country and many other patient and consumer organisations and other stakeholders about the original provisions of the Bill, and for acting on them, as evidenced by not just my new clause but the Government's amendments, both those that they have tabled today and those that were tabled and made in another place. We are also grateful for the Government's attitude in Committee, which I think Members will agree was, broadly speaking, most of the time a very constructive and cooperative place.
	I mentioned the other Government amendments because my new clause makes sense, and has the force that I believe it can have, only if it is viewed in the context of the other amendments tabled, here and in the other place, by the Secretary of State. Collectively, I hope that they represent a tangible and real response to the three big calls that have been made: first, for measures of independence to be brought to bear where necessary to resolve disputed cases within the NHS redress scheme; secondly, for specialist legal advice or representation to be available, where appropriate, to empower patientsI use the word empower rather than entitle, which I know, in the context of this NHS scheme, the Minister does not likewithin this NHS process; and, thirdly, for measures to ensure that patient safety lessons are learned and implemented and seen to be learned and implemented.
	By placing a general duty to promote resolution under the scheme, my new clause seeks to ensure that all the provisions already made possible by the other amendments will have to be considered before proceedings can be finalised. The new clause appears to be quite general, bit I think it can be very powerful, because it is an enabling measure that gives force to all the other amendments that have been made, here and in another place. Crucially, it would mean that where the NHS scheme member's initial conclusion is not to offer redress but the patient feels, having received independent, specialist legal advice to that effect, that they should be eligible, consideration would have to be given to the use of joint instruction of medical experts as a means of seeking resolution, becausethe Minister looks at me quizzically, but I know he will agree with my becauseall possible instruments within the scheme would have to be examined and eliminated before having recourse to civil proceedings. In some disputed cases, that might well result in bringing independence to bear on the assessment of eligibility for redress, rather than just establishing the facts of what happened, as others, not least on the Opposition Benches, have sought.
	In some such disputed cases, it would mean that the patient was empowered through specialist legal advice and representation jointly commissioned from independent sources, but within the scheme. If an independent medical expert assessed that there was negligence and causation, the expectation would be bound to be that there would be an offer of redress.
	The new clause and the amendmentslargely the Government amendmentsmade here and in another place would help to ensure that patient safety lessons were learned and implemented if the independent medical expert identified in the report the salient risk management issues. In other words, the positive experience from the resolve pilot in England and the speedy resolution pilot in Wales would be put to good use, just as I arguedwith some sympathy across the Houseon Second Reading and throughout the Committee stage.
	The crucial point is that the original ethos of the schemeputting the emphasis on the NHS itself and recognising where it has been negligent, and the NHS proactively putting things right and offering redress within its own owned NHS schemewould be safeguarded, empowered and furthered by the new clause. The process that I have described of joint instruction would be necessary only if and when the NHS's assessment did not tally with that of the patient and the legal adviser. That is my interpretation of the overall effect of this enabling new clause and of the combined effect of my new clause with the various Government amendments that it seeks to enable. I would be grateful for a few words from the MinisterI have no doubt that they will be forthcomingabout how that tallies with his interpretation. Kindly, he has already written to me about that so I have an idea what he might say. Given the effect of the new clause and the amendments that it seeks to enable, I believe that we have the framework of a scheme that could enjoy public confidence and deliver real benefits to patients and the NHS.

John Baron: We have made it clear that we support the sentiment behind the Bill and therefore we have no problem in supporting the sentiment behind the new clause. In many ways, it is inherently obvious and what it says goes without saying. It could be argued that that raises the question of why it has to be included in the Bill. The Minister will be fully aware that we welcome and support the good intentions underlying the redress scheme. Our problem is that we have difficulties with some of the detail and content of the operation of the Government's proposed scheme.
	It is ironic that the new clause refers to
	the desirability of redress being provided without recourse to civil proceedings.
	In many respects, and with due respect, those words could be construed as misleading. If the Government have their way, the redress scheme will replicate the difficulties of the civil litigation scheme instead of representing a genuine alternative to litigation. That is anything but desirable. The Government are proposing that the role of lawyers be extended to any stage prior to the offer, including the joint instruction of medical experts. However, the redress scheme is not conceived as a judicial process, so the question of legal representation should not arise. Legal rights are not being asserted or defended. Thus there will be lawyers involved in a process that is non-determinative and non-binding. The scheme will not ensure the closure, certainty or finality of a court process. It will attract the problems of civil legal proceedings, such as expensive lawyers, protracted cases and complexity, without the good aspects of the judicial process, such as finality and independence. It is, in many respects, a lose-lose situation.
	I suggest to the hon. Member for Birmingham, Erdington (Mr. Simon)I think that he almost conceded this point in his remarksthat the new clause is legally meaningless. As a matter of statutory construction, it merely provides for an expression of good intent. It does not bestow any legal rights. It neither confers a power, nor prescribes a duty. Instead, it expresses a requirement that there must be regard to
	the desirability of redress being provided without recourse to civil proceedings.
	In legal terms, it is meaningless. It is not enforceable and would not appear to give rise to legal remedies, whether in public law or private law. In many respects, his new clause is empty. It does not bring anything new to the Bill or to the present situation as it stands. The NHS Litigation Authority, for example, has always had the power to settle cases. The health service has always had the power to resolve claims without recourse to civil proceedings. In short, because the provision will have little basis in reality if the Government have their way, we suggest that the new clause is unnecessary. It is a bit of waste and so we will not waste the House's time in forcing a vote on it.

Andy Burnham: I thank my hon. Friend the Member for Birmingham, Erdington (Mr. Simon) for the constructive way in which has engaged with me and the Department on the Bill. I thank him for facilitating the meeting that we held with AvMA between the conclusion of the Committee and today's proceedings. To complete the tribute to him, I should compliment him on his parliamentary drafting skills, which are clearly excellent.
	As I understand it, the new clause imposes a general duty to promote resolution under the scheme. Under the new clause, a duty will be imposed on scheme members and the scheme authority to have regard, when carrying out their functions under the scheme, to the desirability of settling the case. Scheme members and the scheme authority should have particular regard to the desirability of settling under the scheme, rather than leaving cases to be pursued through the courts.
	I welcome the new clause and the approach that my hon. Friend seeks to achieve through it. He is right to say that it should be seen in the context of the Government amendments. I should say to hon. Members, including the hon. Member for Romsey (Sandra Gidley), that we have listened between the Committee stage and the Report stage. We have taken on board comments made by hon. Members on both sides of the House and we believe that the Bill will be strengthened through making those amendments. In my view, the new clause re-enforces the positive front-foot spirit that we want the Bill to encourage.
	The Bill and the redress scheme to be established under the powers in the Bill aim to open up access to justice for the less articulate, the less wealthy and those who traditionally would have been fed up and abandoned the legal process before a case was completed. Under the new clause, if providers of NHS services believe that there might be a case of negligence, they would be expected to take cases forward. An active approach to redress will be required under the scheme. To be effective, it is important that the NHS is not defensive. The NHS must do all that it can to identify and, where appropriate, resolve cases falling under the scheme.
	My hon. Friend the Member for Birmingham, Erdington was absolutely right to say that the spirit of the Bill is about empowering patients, providing information to them and ensuring that we address their needs when harm has been done. I urge him to see the Bill in the context of other reforms that the Government are making in the national health service to ensure that it is a service that focuses on the individual patient and that patient's experience of the health service, and on ensuring that, when things go wrong, redress to the patient is the thing that matters. I am confident that the NHS redress scheme has the potential over time to effect culture change in the NHS, although I readily acknowledge that that is never an easy thing to achieve. There will be scheme members who are already taking an active approach to complaints and to clinical negligence cases. Some organisations will be prepared to be open and honest, and will embrace the principles of the redress scheme, but there will be others who may continue to be defensive, drag their heels and have a less than positive approach to these matters. We need to do all that we can to ensure that that does not happen.

Andy Burnham: My hon. Friend sums up the new clause extremely well. It is not at all empty or superfluous, as the hon. Member for Billericay sought to claim. It does indeed involve a wide, general duty, but it sets the whole tone for how scheme members should carry out their duties and use the measures and avenues that the scheme puts at their disposal. In making decisions, they are at all times legally required to consider the desirability of concluding matters under the scheme. I emphasise to the hon. Gentleman the word concluding, because there is a need for finality, and for giving patients an early apology and explanation of the steps being taken to prevent incidents from happening again. All that is enshrined in the new clause.
	I am anxious to avoid cases being brought under the scheme, only for some of the old thinking to prevail so that at the point at which they may be settled they are pushed into the legal process. That would lead to duplication of expense and resource, which would not be in the interests of the taxpayer. I believe that we will avoid that by having a clause that promotes the desirability of settling. I am sure that hon. Members in all parts of the House can think of cases, not only in the NHS but in other parts of the public sector, in which individuals have been stonewalled and pushed into pursuing a legal action against a public body, possibly in the hope that they will get fed up and give up, having been ground down by the seemingly interminable process in which they find themselves. That process, which comes about because individuals in organisations will not accept that they have made mistakes and apologise for them, can be extremely wasteful of public resources. It can also ruin people's lives because they become consumed by a case that ultimately has to be pursued through the courts. As I understand my hon. Friend's new clause, it is precisely that situation that it seeks to avoid.
	The new clause signals that the redress scheme is not simply a process parallel to that in the courts but is intended to be the primary means by which disputes arising out of NHS hospital services are, where reasonably practicable, to be resolved, rather than leaving cases to be pursued through the courts. It is drafted in general terms, imposing a general duty to promote resolution. My expectation is that at each stage of the proceedings, the scheme member and/or the scheme authority, if they are considering giving up on the scheme for a specific case, must have regard to the desirability of settling under the scheme. At that point they should consider the means that they have at their disposal, such as the joint instruction of medical experts, and positively consider whether it would be right to take that course of action given the desirability of settling and the awareness that the case may continue by the legal route.
	The new clause is entirely in keeping with the spirit of the Bill that we have put before the House. It is consistent with the open learning culture that we want to see in the NHS, in which mistakes are identified and acted on at an early stage and in which redress is offered as early as possible. In reinforcing that duty, the new clause adds significantly to the Bill, and I am pleased to signal to my hon. Friend that the Government are prepared to accept it.
	 Question put and agreed to.
	 Clause read a Second time, and added to the Bill.

Madam Deputy Speaker: With this it will be convenient to discuss the following: Government amendments Nos. 9 and 10
	Amendment No. 4, in clause 6, page 4, line 23, at end insert
	'(g) about the publication of a report of the independent investigation in accordance with paragraph (a)'.
	Government amendments Nos. 11 and 16 to 18.

Andy Burnham: In Committee, the point was well made, particularly by the hon. Member for Romsey (Sandra Gidley) and my hon. Friend the Member for Stoke-on-Trent, Central (Mark Fisher), that patients harmed during their NHS care often say that they do not want it to happen to anyone else. I have never been at odds with that statement. Those are normally the first words out of the mouths of people presenting at our constituency surgeries when they seek to pursue a case and confront the NHS with the harm that they have suffered through its failings. For many individuals, redress and closureto use that terrible wordmay often mean being clear in the knowledge that measures have been or will be taken to ensure the mistake does not happen again.
	I was asked by the hon. Lady and others to consider an amendment to the Bill to provide for a report on action to be taken to prevent similar cases arising in the future, and for that report to be made available where appropriate. I am pleased to say that having considered this matter carefully I have tabled such an amendment. The amendment, to clause 3(2), provides that redress will now ordinarily include the giving of a report on the action that has been or will be taken at local level to prevent similar cases arising.
	As was accepted in Committee, there will be occasions where mistakes can simply be ascribed to genuine human errormistakes where no procedural changes need to be made and where a report of this type will not be appropriate. As I said in Committee, we must be careful about placing extra administrative burdens on the NHS. I believe that the hon. Lady accepts that caveat. In these specific types of circumstance, the scheme may provide that a report will not be necessary, although ordinarily such a report will now be provided. Therefore, not only will scheme members publish an annual report about lessons to be learned from cases under the scheme, under clause 10, but the redress offered to individuals under the scheme will now ordinarily include a report on the specific action to be taken to prevent a similar mistake happening again in that patient's individual case. I think that that was what the hon. Lady was urging me to do, and she was right to do so.
	On amendments Nos. 4, 10 and 11, I listened carefully to what was said in Committee, particularly by my hon. Friend the Member for Birmingham, Erdington (Mr. Simon), about the reasons why investigation reports should be provided to individuals if requested. He focused on the importance of providing the full facts, not only to those to whom offers are made under the scheme, but to those to whom an offer is not made and whose case is terminated. He spoke about the sense of grievance that people may experience if they are not eligible for redress and he explained why they should, if they so wished, be provided with the facts and the outcome of the investigation, so that they could understand why they were not entitled to the redress that they sought.
	Amendments Nos. 10 and 11 require the scheme to provide for the findings of an investigation to be recorded in a report, and for the report to be made available to the individual seeking redress on request. As I stressed in Committee, clause 3(2) already ensures that an explanation will ordinarily be provided under the redress scheme. It will be a full explanation, and we envisage that in a number of casesparticularly the more straightforwardthe patient will be satisfied with that explanation. We want to reduce unnecessary bureaucracy for scheme members, and we do not wish to impose on them the extra burden of providing the investigation report in every case. In someperhaps manycases, an explanation may be adequate, but our amendments ensure that, if it is requested, the investigation report will ordinarily be provided.
	The amendments enable the scheme to provide that the report need not be made available before an offer is made, or before proceedings are terminated. That, too, is intended to reduce the administrative burden on scheme members. Providing investigation reports at an earlier stage may result in increased correspondence and delay. It is envisaged that when the offer of redress is made, a copy of the investigation report will be sent to the individual, if they request it. That will give the individual a complete set of documentation that they can consider with their legal adviser when the offer under the scheme is assessed.
	The amendments enable the scheme to specify other circumstances in which reports need not be provided. That covers rare cases, such as those in which the person seeking redress is not the patient, so it is considered appropriate to withhold certain confidential health information. Including in the Bill an explicit requirement that investigation reports generally be provided to individuals is in the spirit of openness that the scheme seeks to engender. That will reinforce our messages about more open apologies and explanations.
	In Committee, the Bill was criticised because it was said that the investigative process could not be transparent if its findings were not open. I hope that the amendments satisfy hon. Members that we fully intend the investigative process to be transparent. There is no question but that investigation reports will generally be available, if requested. That will be in addition to the explanation provided to the individual complainant. I would like to make it clear that the investigation report will not be kept back on the ground that it is privileged, nor will it be claimed that investigation reports are without prejudice and inadmissible in any subsequent legal action. That matter was raised in Committee by the hon. Members for Billericay (Mr. Baron) and for Eddisbury (Mr. O'Brien), and I am happy to give an assurance on that point.
	The power in proposed new subsection (2B) is an enabling power. Under the scheme, no report need be provided until an offer is made, or until proceedings under the scheme are terminated. As I have said, the intention is to reduce the administrative burden on scheme members, but in clause 15 we have a specific power to make different provision for different cases, and to exercise powers subject to exceptions or
	in relation to any particular case or class of case.
	The power to restrict the provision of investigation reports may therefore be exercised only in relation to particular cases or a class of cases. Our intention is that the power will not be exercised in cases in which it is appropriate for a joint medical expert to be instructed. However, it does not prevent investigation reports from being provided until the final stage. My hon. Friend the Member for Birmingham, Erdington was concerned about that problem, but I can assure him that the Government amendments do not require reports to be provided at the end of the process in all cases. There is flexibility in the Bill so that investigation reports can be provided to individuals at an earlier stage if that is deemed necessary. He was right to press me on the issue, because if people are to make an informed judgment on the instruction of a joint medical expert they need to see the contents of the investigation.
	The Government amendment further weakens the need for independent investigationsa subject that we will debate in the next group of amendments. However, there is no question but that investigations will be open. The actions of scheme members in conducting the investigation, the scope of the investigation and the processes followed will be open and subject to scrutiny. We have introduced a general duty to promote resolution by accepting new clause 1, which deals with the desirability of settling, and the amendment clarifies the need for openness and transparency. Taken together, the provisions strengthen further the NHS redress scheme.
	Turning now to Opposition amendment No. 4, hon. Members will realise from my earlier comments that I agree that investigation reports should generally be made available to individuals. I am afraid to tell the hon. Member for Billericay that I reject his proposal for a number of reasons, although I accept that it attempts to achieve a similar goal to our provisions. First, Government amendments Nos. 10 and 11 go further than his amendment, which enables the scheme to provide for reports to be made available but does not require it to do so. If the power is not exercised, the scheme could not make provision for the publication of investigation reports. The Government amendments require the scheme to provide for reports generally to be made available when requested.
	Secondly, the amendment refers to
	the publication of a report,
	but I do not believe that publication is appropriate. Investigation reports deal with an individual's health care and contain personal, often confidential, information. It is right that they should be made available to the individual whose health care has resulted in harm, but it is not right that they should be more widely available. Even if anonymised, some scheme members will have so few redress cases, or so few cases of the kind described, that the individual patient could be identified in a published report.

Sandra Gidley: I welcome especially amendments Nos. 8, 9 and 10 and other consequential amendments. As the Minister said, we discussed the subject at some length in Committee. He seemed genuinely engaged and said that he would reconsider the matter. I therefore thank him for doing that because it is the first time that that has happened to me in my six years in this place.
	I am delighted that the Bill includes a clear statement that a report should be produced on action to prevent a recurrence of similar cases. As the Minister says, people mainly want to know that the likelihood of what happened to them recurring will be reduced. Many people's prime motivation is not money. We need to be clear about that in our discussions today.
	I, too, am concerned about Government amendment No. 11, especially proposed new subsection (2B) to clause 6. The Minister claims that there is some flexibility and that the general aim is to provide a report, but it is still not crystal clear in what circumstances the report will be provided when the scheme is about to be terminated or an offer has been made. Some guarantees about that would be welcome because, although I do not doubt the Minister's good intentions, the Bill now includes a clause that will enable future legislators and Governments to take a step back from what the Minister appears to claim. That is worrying.
	I, too, regard it as fundamental that a copy of the investigation report is available to all parties, bringing together the facts of the case as soon as possible so that everybody can reach a clear decision about what has gone wrong and the action that needs to be taken. The facts need to be on the table before we move to the next stage. Liberal Democrat Members disagree with the Government because we believe that an independent, separate stage is vital to the long-term success and acceptability of the scheme. Sadly, there will probably be further disagreement about that but I shall not repeat the arguments at this stage.
	I am worried that the report is available only on request. Although the ability to ask for a report is a step forward, I believe that the emphasis is slightly wrong. As has been said, it is not clear what extra bureaucratic burden making available a report, which has already been prepared, puts on the NHS. What reassurances will there be that patients under the scheme will even know that they have a right to ask for the report. Will that be part of the explanation process? How will they become aware of that? There is a host of legislation, but there is also a great deal of ignorance among the public about what is and what is not available. At the very least, there needs to be a clear procedure for informing a patient about any report. Perhaps there should be an opt-out rather than an opt-in, because I fully accept that there might be a small number of cases where patients, for a variety of possible reasonsthey might have had a mental health problem associated with the report, or they might not want to be reminded of thingsare not interested and do not want to see it. However, everybody should know that such a measure is available and be able to access it.
	Amendment No. 4 has cross-party and independent support. It makes it clear that there needs to be an independent investigation and that a report of any such investigation needs to be published. It also makes it clear that that needs to be an integral part of the process, rather than merely of the end of the proceedings. The Minister has clarified that point.
	Although I welcome the Government amendments, there are still a few small areas where refinements could be made to make the final version of the Bill clearer.

Nick Hurd: I rise to support amendment No. 18, and to place on the record my gratitude to the Minister for having had, like the hon. Member for Romsey (Sandra Gidley), my first experience of a Government Minister actually listening to meunlike at the current moment. The amendment might change only one small wordmay becomes mustbut that is the right thing to do, because it sends a stronger signal about the Government's intentions and, as the Minister probably recognises, the central challenge here is how to generate trust in the Government proposals. Central to that is the perception of transparency and the sending of a signal that the Government understand what motivates people in this context. The Minister and other Committee members were very clear that a large part of people's motivation is to try to make sure that what they suffered is less likely to happen to other people. An annual report will play a part in that process. I also congratulate the Minister on listening to the arguments made in Committeeprincipally by the hon. Member for Romseyin favour of stiffening the requirements of explanations to include reports on further actions taken, where appropriate.
	May I press the Minister on one point? In Committee, he was concerned about the administrative burden that this might involve the system in. Is he any clearer on the figureshe did not have them to hand in Committeeas to what proportion of cases, on a current run rate of about 5,000 cases a year, are down to human error or basic actions that would not require a report of the kind under discussion?

Andy Burnham: Of course, the report is not independent, as the hon. Gentleman just claimed, but the report of the scheme member to the NHS Litigation Authority. The purpose of proposed new subsection (2B) is to address the point that I made a moment ago. Ordinarily, most cases will not deserve a flurry of paperwork as the investigation goes on; many will be relatively straightforward. At the point at which redress is offered, the package that the individual receives will include: an explanation; if necessary, an apology; as other amendments that we have tabled make clear, an explanation of how lessons will be learned and action taken to prevent similar events from happening again; an offer of financial compensation; and, on request, a copy of the investigation report will be provided.
	A scheme member cannot opt out of that package, because the Bill places such a requirement on them. However, paragraph (b) of proposed new subsection (2B) allows for other circumstances, and in doing so deals with the issues raised by the hon. Member for Wyre Forest (Dr. Taylor) and the question of confidentiality. My guess is that the number of such cases would be small, but there may be occasions when it would not be appropriate for investigation reports ordinarily to be provided. It is right to seek in primary legislation to create the flexibility to allow for such circumstances.

John Baron: I beg to move amendment No. 1, page 4, line 16, after first 'the', insert 'independent'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following amendments: No. 2, page 4, line 16, at end insert
	'in accordance with the rules of natural justice such that the person overseeing the investigation is independent of the trust under investigation (such investigation to be confined to the facts of cases and not to consider issues of liability in law, whether civil or criminal).'.
	No. 3, page 4, line 19, at end insert
	'( ) about the assessment of liability in tort under the scheme.'.
	No. 6, in clause 11, page 6, line 28, at end insert
	'save for the investigation of the facts of cases in accordance with subsection 6(2)(a)'.

John Baron: This group of cross-party amendments reflects our concern that the NHS redress scheme, as envisaged in the Bill, lacks independence. This represents a missed opportunity to create a mechanism that will have the full confidence of patients and therefore provide a meaningful alternative to going to court. This is the key dividing line between the Government and the Opposition. I speak also for the Liberal Democrats and for the hon. Member for Wyre Forest (Dr. Taylor) when I say that we believe that the fact-finding stage of the investigation must be independent. The Government do not agree. The Minister explicitly conceded that in stark terms in Committee, when he said that the scheme is not independent. In other words, the investigation will be conducted internally by the NHS. The very trust being investigated will be investigating itself.
	We believe that to be fundamentally wrong for a number of reasons. The first relates to the principle of natural justice. The NHS should not be its own judge and jury, as that represents a clear conflict of interest. Independence is a basic principle of natural justice enshrined in the rule against bias that no man, or woman, should be a judge in his or her own cause. We have consulted widely on this issue, and there is widespread concern outside this place about the lack of independence in the Bill.
	There is also an issue of credibility. Independence is a pragmatic necessity, in the sense that an investigation without the badge of independence would lack credibility and fail to inspire the confidence of patients. That point was acknowledged by the Constitutional Affairs Committee, in its report Compensation Culture: NHS Redress Bill, published on 1 March 2006.

John Baron: It is very straightforward, and I am sorry that the Minister is having trouble with it. We are suggesting that whoever oversees the investigation should be independent of the trust in question. I hope that that is a simple concept to understand. That is the best way of importing independence into the scheme. We are trying to avoid the situation where the trust being investigated conducts the investigation itself. As this is enabling legislation, we are trying to import into the Bill the concept and principle of independence, something to which I think that the Ministercertainly, he suggested this in Committeeis totally opposed.
	I return to the point acknowledged by the Constitutional Affairs Committee in its report, Compensation Culture: NHS Redress Bill, published on 1 March 2006. It stated:
	We are concerned that if the organisation which is responsible for defending trusts and hospitals is also charged with running the scheme, there may be a perception (whatever the reality) of a conflict of interest.
	That is terribly important. A change of culture within the NHS is desperately needed. At the moment, too many patients are frustrated by their inability to get to the truth, because they see themselves as fighting a bureaucracy that is not willing to co-operate. However, one cannot change the culture of a massive organisation such as the NHS by flicking a switch in Whitehall or through exhortation, as long as the trusts and individuals involved have an organisational and professional interest in the casea conflict of interest. Patients want an independent fact-finding investigation, in which they have faith because of its independence. There can be no substitute for that. In patients' eyes, independence will guarantee an honest assessment of the facts.
	To illustrate the point, I briefly beg the House's indulgenceI am sure that all Members will have examples of constituents who have struggledto recount a very sad case from my constituency. A daughter of the family in question suffered brain damage as an infant but survived into young adulthood. Sadly, she died unexpectedly, shortly after abdominal surgery. Even to a laymanit is a matter of common sensethere was a striking temporal relation between the occurrence of the operation and the occurrence of her death. It required some explanation. However, the cause of death certificate made no mention of the recent surgery. There has been a post-mortem examination, but the pathologist made no mention of the recent surgery in determining the cause of death. The death had apparently not even been reported to the coroner immediately following its occurrence.
	Months later the death was reported to the coroner, who declined to hold an inquest. Eventually, two years after the death and following much campaigning by the familyand several letters of robust representation from methe coroner was persuaded that the death was a matter into which she ought properly to inquire.
	I do not know and cannot comment on why the cause of death certificate and the pathologist's determination of cause of death did not refer to the recent operation. I can say, however, that the doctors who dealt with those matters were connected with the hospital where the events took place.
	The familyMr. and Mrs. Sharp, who have obviously given me permission to raise the case herewant a factual explanation. That is all that they have ever wanted. Only then can they decide whether further action is required. They want an honest investigation of the facts, and have made it clear to me that that can only be brought about, in their minds, if the investigation is independent. Unfortunately, however, that request and many like it are being ignored by the Government.
	The Government have made clear, especially in Committee, that what is more important to them is for the NHS to take ownership of the scheme. That was reinforced by the Minister in Committee. The Government want the redress scheme to be an internal system that the NHS will feel that it owns and controls. But that is precisely why people might not have confidence in the system. They have already been battling with an internal system for years, and they are very frustrated by it. They want change, and they want independence. Without independence, any redress scheme risks lacking credibility.
	The amendments are also about separating fact-finding and fault-finding for the purpose of the scheme. We have specified that independence must relate to the fact-finding stage of the scheme, because establishing the facts must precede any assessment of liability. Both the Minister and the Secretary of State have conceded that there is a practical and logical distinction between fact-finding and fault-finding for the purposes of the scheme, and have also conceded that the Government's proposed scheme is itself a two-stage process.
	On Second Reading, the Secretary of State said
	The trust would investigate and ascertain the facts and, with the patient's consent, would refer the case to the scheme authority, the NHS Litigation Authority, to establish liability and an appropriate level of compensation.[ Official Report, 6 June 2006; Vol. 447, c. 30.]
	The Minister explicitly confirmed that in Committee, and that is exactly what we envisage. The principle underlying the distinction is set out in the Inquiries Act 2005 in relation to the coroner's inquest, and its logic is readily acknowledged in our courts.
	If an additional endorsement of that logic were required, we would need look no further than the Inquiries Act itself. The Act provides that an inquiry has no power to determine a person's civil or criminal liability. The explanatory notes state
	There is often a strong feeling...that an inquiry should determine who is to blame for what has occurred. However, inquiries are not courts and their findings cannot and do not have legal effect. The aim of inquiries is to help to restore public confidence in systems or services by investigating the facts and making recommendations to prevent recurrence, not to establish liability or to punish anyone.
	The Inquiries Act provides that an inquiry is not to be inhibited in the discharge of its functions by any likelihood of liability being inferred from findings of fact or recommendations that it makes. The explanatory notes state that
	it is not intended that the inquiry should be hampered in its investigations by a fear that responsibility may be inferred from a determination of a fact.
	It is important for the investigation of facts not to be contaminated by considerations of fault, either by the NHS Litigation Authority with a mind to defend the NHS or by lawyers asserting rights on behalf of the patient.
	Given that we and the Government agree that a two-stage process exists, the only issue is whether the investigation of the facts ought to be independent. We propose that the person who oversees the investigation of the facts must be independent of the trust concerned, as we have discussed. We believe that there is no other way of ensuring real independence. Rather than referring to independent fact-finding, however, the Minister has referred to various mechanisms to safeguard patients' interests.
	We suggest that those are leaky buckets that do not hold water. The Secretary of State, on Second Reading, and the Minister, in Committee, referred to a variety of those. In our view, they cannot offer the reassurance to patients that genuine independence would provide. For example, the Minister suggested that free, independent legal advice on an offer or settlement would import elements of independence and safeguard patients' interests. But that is not the same thing as an independent scheme. Participation by independent lawyers in a process does not transform a non-independent process into an independent one. Moreover, lawyers are not independent, but have to act on someone's instructions.
	The Minister has also made great play of free, independent medical expert advice. I suggest that that is an empty assurance, because expert advice should be independent anyway, or it is not worth the paper it is written on. If it is not independent, it is not expert opinion at all, but advocacy. The person overseeing the investigation at the trust level would have the right to obtain independent medical expert advice in order to help to ascertain the facts, so the Government's assurance that free, independent medical expert advice would help does not add anything.

John Baron: The Minister referred to amendments that were proposed in Committee, but I suggest that he confine himself to those tabled for today's Report stage in the House. He seems unable to accept that we are trying to push for the principle and concept of independence. He has not refuted my earlier suggestion that he does not believe that the redress scheme should be independent, so there can be no merit in going into detail about how we would secure that independence. We are using the amendments to introduce the principle and concept of independence into the Bill.
	The Minister has tried to attack our proposal that the redress process should be independent by suggesting that it would be more expensive. The Government have conceded, however, that in both their and our proposals there is a two-stage process; the fact-finding cost is, therefore, fixed, inevitable and unavoidable whoever oversees the investigation. There is no question of duplicating bureaucracies and so no question of additional cost. Indeed, our proposals could actually save money as they would inspire greater confidence in the scheme and thus better avoid costly litigation.
	In addition, the Minister has contrived the idea that an independent fact-finding process would be adversarial, accusatory or finger-pointing, but that makes no sense at all. There is a basic legal distinction between an adversarial process and an inquisitorial one. An inquisitorial process is concerned with fact-finding, not fault-finding; there is no sense in which such an investigation would reinforce a blame culture in the NHS. Indeed, our proposal for an independent fact-finding process would ensure that the proceedings were not adversarial, as no lawyers would be present and no legal rights would be asserted or defended.
	The Minister talked about promoting a culture of openness and honesty, in which the NHS takes responsibility for its own mistakes. He implied time and time again that because our proposal would require an independent outsider to go in and consider what went wronghe referred to that point again earlier todayit argued against a culture of openness in the NHS and would encourage NHS staff to close ranks and clam up. But that is absurd. If the openness the Minister is talking about is all in-house and not exposed to outside scrutiny, it is not openness at all. There is a fundamental contradiction between the Government's desire to promote openness and the Minister's reluctance to allow an independent person to oversee the investigation of the facts.
	In Committee, the Minister tried to ridicule our suggestion for an independent fact-finding process by talking about people snooping on trusts. He criticised the Opposition for not trusting NHS professionals to carry out an investigation into their own case, but that is a matter neither of snooping nor of trust. What exactly does the Minister believe that the NHS has to fear if his intention is to promote openness and honesty?
	I fear that the Minister has taken the problem at the heart of medical errorthe blame culture and the reluctance to admit mistakesand institutionalised it. Instead of challenging and confronting the problem, he has built his system around it. His non-independent scheme seeks to insulate the NHS from outside investigation even when such investigation is of a fact-finding rather than a fault-finding nature. He has set his heart on a non-independent scheme and will dredge up as many bad arguments as he can to support it. Saying that lessons should be learned, but only if they are the lessons the trust wants to learn, is not a genuine commitment to learning lessons or to changing the culture of the NHS.
	In conclusion, I return to my theme: independence is right both in practice and in principle. It complements the culture of openness the Minister is trying to promote. It would not be accusatory because we would separate fact-finding from fault-finding; we would keep the lawyers and the finger-pointing out. It would allow lessons to be learned and would reassure the patient. That is the most important point, because without independence, the investigation of facts, which will eventually give rise to an assessmentnot a determinationof liability and a possible offer of compensation, will not have the confidence of patients. In the worst case scenario the redress scheme would not be a meaningful alternative to going to court, and because of the importance of the issue I intend to test the opinion of the House on the amendment.

Sandra Gidley: I am on your side hereremember?
	I conducted that poll to get a feeling for the attitude of various grass-roots employees of the NHS. I asked for their thoughts in a very neutral way, without prompting. There seemed to be a considerable consensus that a completely in-house investigation causes problems, not necessarily because of a lack of desire for openness, but because often internal tensions and loyalties come into play and are played on in a way that can be unacceptable. For that reason, there seem to be a number of people who strongly support the concept of independence.
	I was accused of being unscientific, but, as the hon. Member for Billericay (Mr. Baron) said earlier, a number of bodies support this concept. I think we have to approach it from a patient perspective, because unfortunately patients can sometimes have a deep mistrust of the NHS. When things are going well, people have nothing but praise, but when things go wrong, time and again there is the accusation that they all cover up for each other. That perception must be challenged, and that is why the Bill as it stands is so dangerous. I am far from convinced that they all cover up for each other, but it does happen from time to time.
	For those reasons, there is a huge advantage in introducing someone from outside the organisation: people can talk more frankly, as long as the outside person has some powers to access the information that is required to complete the investigation. If that person is independent, the process will have much greater buyin from the public and, I suspect, much greater cooperation from staff who are involved, directly or indirectly.
	The outside person clearly needs to be independent. The Minister questioned us at some length to try to get details of who would employ the person and whether they would be truly independent of the NHS. I confess that I felt that the Minister was taking the view that we, as Opposition Members, often take in Standing Committees, because we are often faced with something fairly broadbrush from the Government and are asked to take a lot of things on trust.  [Interruption.] The Minister says that he explains, and I concede that he has tried very hard to explain, but I can think of numerous Standing Committees in which I have served where the detail of proposals was extremely hazyso the Minister is not exactly unique in this.

Michael Penning: I will speak for only a short timeI am sure that the Minister will be pleased to hear that. I want to talk about natural justice, about which we seldom hear from the Government these days. If patients or their loved ones feel that they have suffered at the hands of the NHS, they have already been substantially hurt and often feel enormously let down. If they are told, Well, it can't be an independent inquiry. The trust will do the inquiry themselves, they will not understand where the natural justice is in the Bill. I am disappointed by what I have heard. I was not on the Committee, but I am on the Health Committee and we have looked at the matter independentlynot in a report, but in relation to the information that has come through. I honestly thought that the Government were going to open things up and allow natural justice in the NHS.
	As a new MP, all too often I have constituents who come to me and say, Would you take my case to the ombudsman? Naturally we have to go through the bureaucratic process of going to the trust and making a formal complaint. My constituents say, Why? It's the trust that's let us down. It's the trust that made the mistakes. How on earth are we going to have confidence in the NHS if we tell them, Don't worry. We've got a brand new Bill. Everything is going to be fine. And, by the way, the trust is going to make the inquiry into your complaint. That is not going to work.
	The Minister should think about this matter carefully. If it were his children or family and he had cause to seek redress, would he be happy to go to the same management and the same people who had been treating his loved ones and perhaps made mistakes? That is where the danger in not accepting the provisions lies. We need confidence in the NHS. The NHS is going through a difficult time.

Michael Penning: In all sincerity, I understand where the hon. Gentleman is coming from. However, the object of any such Bill is the trust of the publicour constituentswho are using the service. I was not saying, in any shape or form, that we should go from the patient having problems and needing redress straight to the ombudsman. However, as the Bill stands, we still have the trust investigating itself. We have moved away from that in other areas of government. The police used to investigate themselves. They do not do that any more, because the public did not trust the methodology. We have moved away from that. I am not saying we should move straight to the ombudsman; I am saying that trust and natural justice should be addressed, which I am sure was the intention of the Bill at the start. That is not going to happen unless there is independence.

Graham Stuart: I cannot think of any reason. The Minister implied that he would like patients always to be provided with a copy of the report. He suggested that when it was not the patient but someone else who asked for the report, it should not necessarily be provided, but such a provision could be included in the Bill. I think that hon. Members in both Opposition parties would urge the Minister to make that change, even at this late stage.
	I am rightly being urged to keep my speech short, but, before I conclude, I ask the Minister to think about the clinicians' point of view. Imagine that, in a trust such as the one that I have described, there was a clinician who was not too popular with the trust's management, and a complaint was received. Who investigates it? Does an independent fact-finder who is experienced in such investigations, and to whom we can look for an objective assessment of the facts, come in from outside? No, the trust's management, with whom the clinician may have a fractious relationship, decides on the facts of the case, writes up the report and may conceivably release it to the patient. Quite possibly, that patient's first act will be to stop at the local newspaper office on his way to the lawyers.

Andy Burnham: I will not respond to that, but I want to ask the hon. Gentleman a question. Does he not accept that it is standard practice, not just in the public sector, but in the private sector, that when a complaint is brought against an organisation, the first stage should be an investigation carried out by the organisation itself? Is the hon. Gentleman suggesting that that does not happen in the private sector? If someone sought to escalate a case before such an investigation had happened, they would normally be told to take the matter back to the organisation for investigation and response.

Graham Stuart: The Minister makes a point with some power to it, but the Government introduced the Bill precisely because the NHS is not investigating itself in that way. It is because the matter is of critical importance, not only to the patient but to the country as a whole, that independence is needed. The police have similar status, and it is similarly important that they should conduct themselves fairly, but it has been decided that they should not investigate themselves.
	The Minister said at the beginning of his contribution that there will not be an independent investigation. That is the message that the Government are sending out. The Minister is telling patients who have been wronged by trusts across the country that there will be no independent investigation. The Government will realise, months or years from now, that it is a mistake to send out that signal and to destroy the good intentions that they had when they set out on this path.

Question accordingly negatived.
	 Amendment made: No. 11, page 4, line 23, at end insert
	'(2A) A scheme must
	(a) make provision for the findings of an investigation of a case under the scheme to be recorded in a report, and
	(b) subject to subsection (2B), make provision for a copy of the report to be provided on request to the individual seeking redress.
	(2B) A scheme may provide that no copy of an investigation report need be provided
	(a) before an offer is made under the scheme or proceedings under the scheme are terminated, or
	(b) in such other circumstances as may be specified.'. [Andy Burnham.]

Andy Burnham: I beg to move amendment No. 12, page 4, line 41, leave out 'subsection (2)' and insert 'subsections (2) and (4)'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following: Amendment No. 5, page 5, line 1, leave out paragraph (a).
	Government amendments Nos. 13 and 14.
	Amendment No. 7, page 5, line 10, leave out subsection (3).
	Government amendment No. 15.

John Baron: The purpose of our amendments is to restrict the role of lawyers, except where legal rights are affectedthat is, at the offer stage. The Minister has accepted that the policy underlying the Bill is to provide a genuine alternative to litigation. Underthe redress scheme, offers may be made on the basisof the NHSLA's internal assessmentnot its determinationof liability.
	Legal rights are not determined but remain intact, as the person concerned can resort to litigation at any time. Accordingly, it is difficult to see why lawyers need to be involved before an offer is made or a settlement is considered, when legal rights may be waived as part of a compromise agreement.
	The Secretary of State agreed with that sentiment on Second Reading. She said:
	I am quite certain that lawyers will argue...that much more legal advice should be made available all the way through the process. If we do that, however, we might as well stick with the existing situation in which people seek legal advice and go to court.[ Official Report, 5 June 2006; Vol. 447, c. 33.]
	However, the Government amendments show that the Government have changed their position. They now want to involve lawyers, in a misguided attempt to enhance the scheme's credibility. I believe that that will make the process more adversarial. Involving lawyers risks causing whoever is involved in the fact-finding investigation to clam up. We do not want lawyers asserting or defending legal rights, as that will import into the process considerations of fault and defensiveness, whereas we believe that the investigation needs to be open and transparent. The Government proposals are the worst of all worlds, and will add to precisely that blame culture that the Minister says that he wants to avoid.
	In addition, there is the question of cost. The more lawyers involved in the investigation, the greater will be the costto the scheme and to the NHS and at the expense of patient care. In other words, if more money is soaked up in lawyers' fees, less will be available for patient care.
	The NHSLA annual report for 2006 came out a couple of days ago, and made reference to the problem. The Government may think that only the Opposition are concerned that ever higher costs will divert resources away from patient care, but the report states:
	The Authority remains concerned about the relatively high legal costs which are often incurred in clinical negligence claims, and which do not benefit either injured patients or the NHS.
	Yet the Government want to involve more lawyers earlier in the process.
	The added costs might be worth while if it could be shown clearly that they added value, but the evidence suggests that they would not. The objective measure of the performance of so-called specialist lawyers is worth considering. In a letter to a member of the public dated 7 November 2002, the Legal Services Commission stated that, since August 1999, only specialist lawyers had been able to start new cases on legal aid. In 2000-01, the overall success rate in clinical negligence cases was 23 per cent. for specialist lawyers, and 24 per cent. for non-specialist lawyers.
	According to a written answer to me on 17 January 2006, in the last year for which figures were available, the overall success rate for legally aided clinical negligence cases had remained at 23 per cent. The figures are revealing. First, they show that about five or six years ago, when ongoing legally aided clinical negligence cases had specialist and non-specialist lawyers, the performance of both categories of lawyers was roughly comparable. Secondly, even though legal aid was made available only to specialist lawyers in 1999, the figures show that there has been no improvement since then in excluding opportunistic and unsustainable claims.
	We feel that lawyers should be restricted to the offer stage. Involving lawyers would replicate the problems of the adversarial litigation system. It would add to the cost of the redress process and subvert its functions, with the focus on compensation rather than on explanation. In many cases, involving lawyers would be the worst of all worlds; it would import the bad aspects of the judicial processexpensive lawyers, protracted cases and complexitywithout the benefits of finality and independence. It would certainly add considerably to the cost of the schememoney that would be better spent on patient care.

It being Five o'clock, Mr. Deputy Speaker  put forthwith the Question already proposed from the Chair, pursuant to Order [5 June].
	 Amendment agreed to.
	Mr. Deputy Speaker  then proceeded to put forthwith the Questions necessary for the disposal of the business to be concluded at that hour.
	 Amendment proposed: No. 5, page 5, line 1, leave out paragraph (a). [Mr. Baron.]
	 The House divided: Ayes 173, Noes 254.

Question accordingly negatived.
	 Amendments made: No. 13, page 5, line 1, leave out 'in connection with proceedings under the scheme'.
	No. 14, page 5, line 2, at end insert
	'to individuals seeking redress under the scheme'.
	No. 15, page 5, line 12, at end insert
	'(4) A scheme that makes provision for the provision of the services of medical experts must provide for such experts to be instructed jointly by the scheme authority and the individual seeking redress under the scheme.'. [Andy Burnham.]

Amendments made: No. 16, page 5, line 29, at beginning insert 'Subject to subsection (2A),'.
	No. 17, page 6, line 16, leave out paragraph (j).
	No. 18, page 6, line 17, at end insert
	'(2A) A scheme must require a member of the scheme to prepare and publish an annual report about cases involving the member that are dealt with under the scheme and the lessons to be learnt from them.'. [Andy Burnham.]
	 Order for Third Reading read.

Andy Burnham: I beg to move, That the Bill be now read the Third time.
	I am pleased to be able to send the Bill back to another place, and I hope that their lordships will give it their blessing. Although there remain some differences between ourselves and Opposition Members that we have discussed today, there is a good measure of consensus on the Bill. There is a belief that this is a good Bill that will change for the better the lives of patients who have been harmed during the course of their NHS health care. I am pleased with the Bill and firmly believe that it has benefited from the scrutiny that it has received. During its passage through this House, we have given it a thorough examination. The Government have listened and responded to points raised in debate, and we have amended the Bill accordingly.
	Importantly, following debate in another place, the Bill was amended to enable the scope of the redress scheme to be enlarged. The scheme may now extend to services over and above hospital services. That addressed concerns that the scheme would be incapable of adapting to the increasing diversity of NHS health care provision, as the NHS moves towards the greater provision of what have traditionally been secondary care services in primary care environments.
	Following debate in Committee, we accepted that redress will now ordinarily include not only an offer of compensation, an explanation and an apology, but the giving of a report on the action that has been or will be taken, to prevent similar cases from arising. I say again that that is what our constituents overwhelmingly want when they come to us with complaints about their NHS treatment. They want to ensure that people in their locality do not go through a similar experience; they want things to change for the better. We have taken on board the fact that patients often want to know what measures have been or will be taken to ensure that the mistake does not happen again.
	We have also accepted that the scheme must now provide for an investigation report to be prepared and given to an individual on request. That was in response to the persuasive arguments that providing patients with investigation reports will better ensure an open and credible investigation. We believe that that will provide additional reassurance to individuals that their cases will be properly investigated, but of course if an individual believes that the investigation by the scheme member falls below the acceptable standard, the ombudsman may ultimately provide an independent review of any complaint.
	Furthermore, the scheme must now require members to publish an annual report about cases dealt with under the scheme and lessons to be learned. We have taken it on board that there should be a guarantee that annual reports on lessons to be learned will be prepared and published.
	Additionally, we have accepted the point, made eloquently today by my hon. Friend the Member for Birmingham, Erdington (Mr. Simon) that there should be enshrined in the Bill the principle of the desirability of resolution under the scheme. That is something to which members of the scheme must have regard in carrying out their duties under it. I am sure that the Simon amendment will have a positive effect in creating the open learning culture in our NHS that I believe Members in all parts of the House would like to see the Bill encourage. I am grateful to him for tabling it.
	We have clarified that the free legal advice that may be provided under the scheme will be provided to the individual seeking redress, and we have inserted a new provision to make it clear, that if the scheme provides for the services of medical experts, those experts will be jointly instructed by the scheme authority and the individual seeking redress.
	I firmly believe that these changes significantly improve the Bill and provide greater reassurance that the scheme established under the powers in the Bill will provide what patients want. As I have said, it is those people who are less articulate and less able to see a case through to the bitter end who may benefit the most from the scheme. In cases where harm has occurred, the NHS will take up the case, investigate it and offer an apology, an explanation and, if necessary, redress. That is clearly in the interests of patients and entirely consistent with the further reforms that the Government are introducing to create an NHS centred around the needs of the individual patient. The Bill will further strengthen the NHS in that regard.
	I thank hon. Members for their contributions today and in Committee. I was pleased to give the hon. Member for Romsey (Sandra Gidley) her first success in Parliament. It was a good Committee, and despite differences on the issue of independent investigation, all Members contributed positively and the Bill is better as a result. I particularly thank my hon. Friend the Member for Birmingham, Erdington, who contributed constructively throughout the proceedings, and who has improved the Bill. I thank my predecessor, my right hon. Friend the Member for Liverpool, Wavertree (Jane Kennedy), who did so much work to prepare and introduce a Bill that is excellent in every respect.
	I thank you, Mr. Deputy Speaker, as well as our Chairmen in Committee and the excellent team of officials in the Department of Health who provided support throughout the Bill's passage. The scheme is excellent, and it will improve the national health service, so I commend it to the House.

John Baron: It is with mixed feelings that I rise to speak on Third Reading. We had hoped to support the Bill, which has the worthy aim providing an alternative to going to court for NHS patients seeking redress, but despite some lively and learned debates, both on the Floor of the House and in Committee, it is significantly weaker than the measure that was brought to the House from another place.
	We thank you for supervising our debates and for your customary patience and guidance, Mr. Deputy Speaker. The principles underlying the Bill were at least tested and clarified during its passage through the Commons; I accept what the Minister said on that point, to a certain extent. I thank the Clerks for their advice on amendments and procedure, which was extremely helpful. I pay tribute to my hon. Friend the Member for Eddisbury (Mr. O'Brien), who served as Conservative Whip in Committee. He gave us the benefit of his legal training on a number of points, and I am grateful to him.
	The hon. Members for Romsey (Sandra Gidley), and for Wyre Forest (Dr. Taylor), helped to ensure that our attempts to improve the Bill were pursued on cross-party lines. I am grateful for their support, which built on the amicable partnership established by noble Friends in another place. I, too, thank all Members for their contributions, both in the House and in Committee. I commend the Minister on guiding his first health Bill through the House, although trying to pin him down on some of the issues has been a game of cat and mouse. However, we can save that subject for another day.
	The overall objective of the Billto provide an alternative to going to court by creating a redress schemehas been widely welcomed. As we know, clinical negligence litigation is complex, costly and basically unfair. Most people do not qualify for legal aid, yet most cases are legal aid-funded. Most clinical negligence cases fail because legal aid is the fuel for unmeritorious claims. A scheme established under clause 1 could widen access to redress and offer patients what they say they want most: a proper and honest investigation into what went wrong, an explanation and, when appropriate, an apologythere is no difference between us on that. Under clause 3, an offer of compensation might be appropriate, but financial redress usually comes far down the list of patient priorities, as a number of Members have said.
	The Minister will know of my great disappointment with the Bill in its current form. I do not believe that the fact-finding stage of the investigation will inspire confidence in patients, because the investigation will not be independent. What is more, the objectivity of the fact-finding investigation is likely to be subverted by the involvement of lawyers under clause 8. Many features of the current disastrous system for dealing with clinical negligence have been imported into the redress scheme, and overall the Bill will not succeed in shifting the culture of the NHS towards one of greater openness and transparency that we all want.
	Clause 6 is the offending article, because it would allow the NHS to act as both judge and jury in investigations by the trusts. We have consistently argued that someone independent of the trust should conduct the investigation. Patients go to court because they want compensation and an independent investigation into what went wrong during their treatment. In seeking to provide an alternative to litigation, we should have regard to that basic need.
	Clause 6 is flawed because it does not address such a need. Instead, it allows for the investigation to be carried out by the trust under investigation. That will not inspire confidence in patients and without that confidence, the Bill is likely to fail. The Minister is aware of this complaint, which has been raised by many hon. Members and by many patient groups. However, he seems to be more concerned with reassuring NHS staff than he is with reassuring NHS patients. He has insisted that under the scheme an investigation of facts should not be independent of the trust. He has argued that trusts should have ownership of the process in order to bring about a cultural shift towards greater openness and transparency, but to most people that is entirely contradictory.
	After all, what could be more open and transparent than inviting an outsidersomebody independentin to consider all the facts? As we have heard, it is a basic principle of natural justice that no man or woman should be a judge in their own case. The same goes for investigation of cases of possible clinical negligence. Because patients understand this principle, our pragmatic complaint against the Bill is that clause 6 will not satisfy those seeking redress. It will not provide an independent exposition of the facts.
	The Opposition have similar reservations about clause 8 which, as amended, will import into the scheme the very feature of litigation that has fostered a culture of finger-pointing and blamethat is, lawyers seeking to assert or defend rights. Lawyers are costly but add limited value to a fact-finding investigation. They have no place in the scheme because individual rights are not being contested. Liability is assessed, rather than determined. They are likely to soak up resources originally intended for patient care, with every incentive to push claims beyond their merits.
	Lawyers need to be involved only where legal rights are being determinedthat is, in relation to an offer of settlement. Specialist legal representation under clause 8 will not guarantee the independence of the investigation. It will merely encourage confusion between fact-finding and fault-finding within the scheme. Accusations of blame will contaminate the objective consideration of facts. That will lead to a more closed and defensive culture among NHS staff. Important lessons will not be learned.
	Again, the Bill works against the stated aims of the Government. It contradicts the opinion expressed by the Secretary of State on Second Reading that lawyers should be kept out of the early stages of the investigation. It also flies in the face of the recommendation of Sir Liam Donaldson, who argued for a move away from the adversarial culture associated with tort.
	My deepest frustration with the Bill is that it adds almost nothing to what can be done already. It is unnecessary, in many respects. NHS trusts already have the power to investigate themselves where cases of possible clinical negligence are identified. The Litigation Authority already has the power to make an assessment of NHS liability and offer compensation accordingly. The Bill simply formalises these existing powers. One of the few new things that it provides is free legal advice. That sounds good, but it could be a costly mistake, as experience of legally aided clinical negligence litigation suggests.
	As amended, the Bill provides for a report on the investigation to be made available to patients, but it then goes on to establish reasons why the report can be withheld in some cases, although I appreciate the Minister's attempt at clarification on the matter. That was revealing, for it shows how the Government's priorities are focused on the interests of the NHS Litigation Authority, rather than on the needs of patients, in some respects.
	In conclusion, we were happy to vote for the Bill on Second Reading, but since then we believe the Government have greatly undermined its potential. The whole direction of travel has been towards a scheme which leaves the trust acting as judge and jury in its own case while simultaneously importing the bad features of clinical negligence litigation. Having damaged the Bill, the Government do not deserve our support. For this reason and with great disappointment, I shall ask my Conservative colleagues to vote against Third Reading.

Si�n Simon: No. Hardly anybody gave way to me in Committee or this afternoon, so I will just make my brief remarks and sit down.
	I spoke more than once on Second Reading and in Committee about different ways in which the Bill could have been dealt with from the beginning and different ways in which it could have been improved throughout. Most fundamentally, if I had designed the Bill, I would not have based it on the rather limiting test of liability in tort, but tried to develop a more modern, flexible and patient-centred avoidability test. For me, that is the key remaining weakness, although there is no reason why such issues should not be considered in future. My hon. Friend the Minister said that the operation of the Bill and the scheme will be reviewed. I urge him to examine those matters in the future.
	On the whole, the scheme and the Bill are good. It could make a genuine difference to people's lives at times of sickness, and to their relations with the NHS when it lets them down and they try to deal with that. I am pleased with and proud of the way in which the Bill has developed and changed. I sincerely recommend it to patients and patient consumer organisations.
	My hon. Friend the Minister has provided a master-class in listening government. He has trodden carefully and chosen wisely. He has done that with tolerance and good humour and won grudging plaudits from some Opposition Members. He has my wholehearted admiration and thanks. Until today, albeit on occasions, most Opposition Members had made a good fist of it, and my thanks and congratulations go to them.
	The Bill was basically good all along. It is now immeasurably better for having been through Parliament. One cannot say either of those things about many measures. Having been involved with a Bill that satisfies both criteria, we should count ourselves lucky and commend it to our constituents and concerned organisations.

Richard Taylor: I shall not keep the Whips from their tea for more than a few moments but I cannot resist telling the Minister that he is in danger of making me change one of my after-dinner speeches. My limited experience of Standing Committees has been uniformly depressing and frustrating. When I served on a Committee a long time ago, a senior Member whispered in my ear that he had tabled 600 amendments and not one was accepted. Yet an amendment to the Bill has been accepted. That is absolutely brilliant and I commend the Minister for that. He will be known as a listening Minister, and I hope that that will not be perceived as a sign of weakness and that he will continue to listen and take points.
	Having said that, I still have two genuine worries. Sadly, I do not believe that we conveyed clearly what we meant by independence. I hope that the involvement of legal representation in the fact-finding part of the investigation will not increase the complexity of the process, make it adversarial or increase the stress levels for patients, relatives and staff. The medical profession abominate the involvement of the legal profession, as I am sure hon. Members realise.
	I hope that, in time, advantages will be perceived in aligning the redress scheme more closely with the NHS complaints procedure, as Making Amends suggested.

Helen Southworth: I am grateful for the opportunity to raise the issue of protection for children who run away or go missing from home or care, especially as I have a ten-minute Bill, supported by many Members, which has not yet secured time for a Second Reading.
	The Children's Society, the National Missing Persons Helpline, the National Society for the Prevention of Cruelty to Children, ChildLine, Parents And Children Together, Railway Children, local charities such as Talk Don't Walk in my constituency, the children's lead of the Association of Directors of Social Services and missing persons lead of the Association of Chief Police Officers, the Metropolitan police and the Police National Missing Persons Bureau have all contributed to the Bill's preparation. The Bill's main purpose is to establish a simple co-ordinating mechanism to identify and implement best practice, monitor what is happening and make sure that it works. In particular, the Bill would place a duty on the Secretary of State to promote the establishment of a national strategy, safeguard runaway and missing children and provide for the collection and reporting of information about runaway and missing children. It is not about creating a bureaucracy; it is about putting someone in charge and making someone responsible.
	What is the current position? Research by the Children's Society indicates that an estimated 77,000 children and young people under the age of 16 run away for the first time every year. It also states that there are around 129,000 incidents of children running away overnight every year.
	Who are the children who run away? Anecdotal evidence suggests a range of circumstances in which children and young people choose to leave home or care. I have been given evidence about very vulnerable children out on their own with no one to help them. In the House, we do not know the nature of the problem or have the information. I asked how many children on the child protection register from each local authority area have been reported missing to the police, and received the reply that the information is not collected centrally. I asked how many children in local authority care were reported missing from care to the police in each local authority area, but the information is not collected centrally. I asked which local authority children's services have agreed joint protocols with their police authorities for the management of cases of children reported missing from home or care. Again, the information is not collected centrally.
	The Every Child Matters: Change for Children programme, is making a huge impact on the well-being of children in local communities. We must have a mechanism, however, to ensure that children who run away or go missing, and who have nowhere safe to go, have help that meets their needs where they are. Protection and services for young runaways must become a priority. Those children can become invisible, and we must not let that happen.
	The police have given me anonymous case histories, and I shall share just a few with the House to describe how hard life can be for some of our children. One is of a young boy living with his mother, stepfather and two older children. At home, his parents, who were heavy drinkers, neglected him, and his sisters bullied him. He was also the victim of bullying at school. He was frequently reported missing to the police, spending nights at the homes of his friends, riding buses or sleeping rough, often with other children who had run away. On two occasions, he presented himself to the local police station, saying that he did not want to go home. Eventually, he was placed in care in October 2003, when he was 13 years old. He has continued to go missing from his care placement, and 220 missing-person reports were recorded between October 2003 and June 2006. While missing, he has been a victim of crime on five separate occasions.
	In 1996, aged six, a young girl first came to the notice of police when her teacher discovered that her mother had assaulted her. During 2002 and 2003, aged 12 and 13, she was reported missing on numerous occasions, and 20 separate incidents were reported on police intelligence records. While missing, she was having relationships with older men who were exploiting her. On one occasion she was interviewed by police, and stated that she was having unprotected sex with her boyfriend with the intention of becoming pregnant. He was 25. She also stated that her boyfriend encouraged her to have sex with other men, in return for which she received favours such as alcohol, cigarettes or money. She was 12 years old at the time.
	The girl was placed in care, but continued to be reported missing on a regular basis. Her foster carer reported to police on one occasion that she was claiming to be carrying drugs from one place to another for dealers. On one occasion, she was found in the flat of a 45-year-old man to whom she was not related; also sleeping in the flat was a known prostitute. The girl was placed in a care home in another county, but has continued to be reported missing from there. Between August 2002 and September 2005, between the ages of 12 and 15, she made 12 allegations of serious crimes, including very serious crimes against the person.
	Another child first ran away from home at the age of 13. She was missing for five days, and it transpired that she had spent most of that time sleeping rough, sometimes in telephone boxes. She disclosed to the police that the reason for her running away had been sexual abuse by her mother's partner. She was placed in a local care home by social services as a temporary measure while police dealt with the allegation. She provided credible evidence of continuing sexual abuse, which had begun when she was 11 years old. Because she was aware of the strength of her mother's feelings for her partner, she never told her mother. Her mother's partner denied the allegations, and her mother refused to accept her daughter's word or to support her. It was decided that she should be placed with a foster carer. Unfortunately, that was in another county. She next came to notice in October 2005, by which time she had been placed with a different foster carer in yet another county. She had run away from foster care, and was found in London. It transpired that she had been engaged in prostitution while she was missing.
	Another child, 11 years old, is on the child protection register as a result of violence in the family home. His father is an alcoholic, and his mother has a drug problem. The parents are together intermittently, and the child has been caught in the middle of a volatile and violent situation for a number of years. He was placed in foster care. He is described as shy and introverted. He remained at school, but his foster carer lived outside the borough, so he had to make the long journey to school in a taxi every day. He is frightened of the dark.
	The child ran away from foster care, taking all his belongings. He was found the next day back with his parents, but because of the situation to which he had returned, he was taken into police protection and was debriefed by the police. He explained that he was frightened all the time, especially when coming home from school, and that he had been bullied at the foster carer's house. Apparently two older teenage boys were also in care at the address. They had been bullying him. He had been locking himself in his room each night, and going to school in the morning without any human contact as such. He was taken by social services back to the foster carer's house, but he promptly ran away again within an hour. He was found very quickly wandering nearby, and has now been placed in alternative care.
	Those are far from isolated cases. Although some young people find that running away can provide a relief from pressure, a large minority find themselves lonely, hungry and frightened. Children on the run are at high risk of abuse, and face both immediate and long-term dangers.
	Across the country, I have encountered some exceptional individuals and statutory and voluntary organisations. They are working incredibly hard to put things right. An example is the mountains into molehills project organised by Lancashire constabulary, who work with all the other key local stakeholders to establish effective advanced problem-solving measures. It is a beacon of best practice. The computerised missing persons case management system allows analysis of missing persons data, which make it possible for problem solving to intervene at an early stage. Lancashire found that of 6,200 missing persons investigations undertaken annually, more than 4,800 involved children under 18. Lancashire tracked children who had been missing more than twice and found 300 children who accounted for almost 3,200 of the missing persons investigations. The majority of those cases involved children in care. One had been the subject of 78 missing persons investigations in a single year.
	Following Lancashire's example, Leicester constabulary has recently carried out work with its key local partners, which revealed that of the 4,241 reports to the police of missing persons, 6 per cent. were reports about the same 10 young people. All were in local authority care, all were reported missing more than 10 times, and one individual had been reported missing more than 53 times during the year.
	It is significant that in the Met police, Lancashire and Leicestershire, very senior police officers, and people at director level in other stakeholder organisations, are taking a lead role. Someone is taking responsibility at the top of the organisations to get action. A common thread identifies a particularly vulnerable group of cross border children with serious social, domestic and behavioural difficulties. They are placed by the local authorities responsible for their care into private care homes in different areas of the country. For a minority of children who need to be placed away from home to protect them from particular circumstances, such placements are appropriate. All too often, however, children are placed inappropriately, without sufficient support and without liaison with local services.
	For children running away from local authority care, the current system is failing to meet their most basic needsa safe place to stay and someone safe to talk to. Children's services, police, the voluntary sector and health services have vital roles to play in ensuring that runaways are known about, found and their problems appropriately addressed. Making sure that the agencies know how to work together effectively is a key dynamic of the Every Child Matters: Change for Children reforms. The need for co-ordinated action was also a central feature of the recommendations made by the social exclusion unit in 2002, and the accompanying guidance issued by the Department of Health. But the co-ordinated action, backed up by effective information collection and sharing, clear strategies and leadership, is not happening everywhere.
	In October 2003, the Children's Society conducted a survey to see how local authorities were getting on with protocols and services for runaways. Some 91 of 150 local authorities replied, of which just under half had developed protocols for runaways. Only seven authorities could say that they had implemented all three of the recommendations. In 2005, a new survey showed that 89 local authorities have all recommendations in place, and a further 25 have committed to fulfilling the recommendations. That is too slow and piecemeal, and is letting vulnerable children down. Children are still running away from danger into danger, which is why we must have national leadership and national accountability to ensure that things happen.
	National voluntary organisations such as the Children's Society, the National Missing Persons Helpline, the National Society for the Prevention of Cruelty to Children and Childline have been seeing the problems and taking action for years, providing places of refuge and someone to talk to. Local projects such as Talk Don't Walk in my constituency are having a real impact, but their funding is uncertaineven though for some children they are the only place the child trusts enough to turn to for help, like the 12-year-old boy who came to a refuge run by a charity, alleging physical abuse and that his dad locked him up at home. The refuge contacted children's services, who returned the boy home with social work support. A month later, he turned up barefooted at the refuge with a fractured arm, saying that his Dad had hit him, taken his shoes away and locked him up. He escaped and could only think of the refuge as a safe place to go. He has since been accommodated and remains accommodated.
	The National Missing Persons Helpline set up a runaways helpline two years ago that took 57,000 calls last yearfunded by the charity. It is an essential service for children such as the 12-year-old who ran away from home after an argument with her mum's new boyfriend. She did not know where to turn. There were two younger children at home and the mum did not realise that her daughter was missing. The runaways helpline connected her to a duty social worker for the first time.